OBJECTIVE: Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. METHODS: More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8-83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. RESULTS: There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI)≤AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. CONCLUSIONS: Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low.
OBJECTIVE: Aortic valve-sparing David procedure has gained broad acceptance. However, few long-term results have been published. We present our results. METHODS: More than 450 David procedures have been performed in our institution so far. Of these, 126 patients were operated between July 1993 and December 2000. Median age was 57 (8-83) years and 46 (36.5%) were female. As many as 26 (20.6%) had Marfan syndrome, 21 (16.7%) had acute aortic dissection type A (AADA) and 67 (53.2%) had additional procedures. RESULTS: There were six (4.8%) deaths in 30 post-operative period (POD), four of whom had AADA. In the follow-up, there were 32 (25.4%) late deaths, 11 (34.4%) of these were caused by cardiac or underlying disease or op-related. As many as 15 (11.9%) patients were re-operated; six (40%) were Marfan patients and two (13.3%) had early endocarditis. Follow-up echocardiography of 76 (60.3%) event-free patients showed valve insufficiency (AI)≤AI I° in 68 (89.5%) and grade II in 7 (9.2%) patients. Leaflet degeneration due to proposed leaflet contact with the straight Dacron graft was not observed. A total of 36 (47.4%) patients were in New York Heart Association (NYHA) class I, 33 (43.4%) in NYHA II, and five (6.6%) were in class III. During the entire follow-up of 790 patient-years, there was no stroke or major bleeding. Survival at 1, 5 and 10 years was 93%, 85% and 70%, respectively. Freedom from valve replacement at 1, 5 and 10 years was 96%, 91% and 87%, respectively. CONCLUSIONS: Regardless of the underlying pathology, valve-sparing David I procedure has acceptable long-term results. Valve-related complications such as stroke or major bleeding is exceedingly low.
Authors: Klaus Kallenbach; Christian Hagl; Thorsten Walles; Rainer G Leyh; Klaus Pethig; Axel Haverich; Wolfgang Harringer Journal: Ann Thorac Surg Date: 2002-12 Impact factor: 4.330
Authors: Klaus Kallenbach; Matthias Karck; Rainer G Leyh; Christian Hagl; Thorsten Walles; Wolfgang Harringer; Axel Haverich Journal: Ann Thorac Surg Date: 2002-11 Impact factor: 4.330
Authors: Rainer G Leyh; Stefan Fischer; Klaus Kallenbach; Theo Kofidis; Klaus Pethig; Wolfgang Harringer; Axel Haverich Journal: Circulation Date: 2002-09-24 Impact factor: 29.690
Authors: Malakh Shrestha; Heike Krueger; Julia Umminger; Nurbol Koigeldiyev; Erik Beckmann; Axel Haverich; Andreas Martens Journal: Ann Cardiothorac Surg Date: 2015-03
Authors: J James B Edelman; Michael Seco; Ben Dunne; Shannon J Matzelle; Michelle Murphy; Pragnesh Joshi; Tristan D Yan; Michael K Wilson; Paul G Bannon; Michael P Vallely; Jurgen Passage Journal: Ann Cardiothorac Surg Date: 2013-11
Authors: Manuel Caceres; Yicheng Ma; J Scott Rankin; Paramita Saha-Chaudhuri; Brian R Englum; James S Gammie; Rakesh M Suri; Vinod H Thourani; Fardad Esmailian; Lawrence S Czer; John D Puskas; Lars G Svensson Journal: Eur J Cardiothorac Surg Date: 2014-03-17 Impact factor: 4.191