Aortic Root Replacement, Valve Sparing according to Tirone David reimplantation technique versus Bentall’s technique, early post operative outcome

Abstract

The modified Bentall – De Bono procedure is considered the standard approach for the repair of aortic root aneurysm, ascending aortic aneurysm or a type A aortic dissection when accompanied by an incompetent, irreparable aortic valve. However, the modified bentall procedure also exposes the patient to the problems associated with artificial valves. Mechanical valves, while long lasting, require life-long anticoagulation. Biological valves, while not requiring anticoagulation, expose the patient to the potential need for re-operation in 10–15 years which, in the case of a re-do modified bentall, is a major and relatively risky operation, the observation that in at least half of the patients the native valve cusps are undamaged led to the development of valve sparing aortic root reconstruction techniques. Operations that replace the aortic root while preserving the valve have been developed by pioneers as Magdi Yacoub (remodelling procedure used since 1979) and Tirone David (reimplantation procedure performed since 1988) in an effort to improve quality of life for many patients.