Abstract
Introduction Aortic valve-sparing root replacement (David's procedure) is an especially appealing
treatment option for young patients. Here, we present the short-, mid, and long-term
outcomes of this operation in adolescent patients.
Methods Between September 1994 and March 2014, 29 patients aged 6 to 21 years underwent the
David-I procedure at our center. We conducted a retrospective study with follow-up.
Results The mean age was 16.8 ± 3.4 years and 90% (n = 26) were male. Marfan's syndrome was present in 86% (n = 25) of cases. Ninety-seven percent (n = 28) of cases were performed electively, and one case (3%) was performed emergently
for acute aortic dissection type A. There were no early perioperative deaths (0%).
Follow-up, which was completed on 100% of patients, comprised a total of 394 patient
years and a mean follow-up time of 13.6 ± 5.4 years. The estimates for survival at
1, 5, and 10 years after initial surgery were 100, 97, and 93%, respectively. During
follow-up, there were four (14%) late deaths and five (17%) aortic valve-related reoperations.
The 1-, 5-, and 10-year estimates for freedom from valve-related reoperation were
100, 86, and 83%, respectively. The perioperative mortality for these five reoperations
was 0%.
Discussion Aortic valve–sparing root replacement can be performed in adolescents with a very
low perioperative risk. Long-term survival seems to be affected by connective tissue
diseases.
Keywords
aorta/aortic - aortic valve and root - aneurysm
