Abstract
Introduction: This paper compares the David and Yacoub procedures for valve-sparing aortic root replacement, two leading techniques for treating aortic root aneurysms while preserving the native aortic valve. Both methods aim to avoid prosthetic valve replacement and the need for lifelong anticoagulation.
Material and Methods: We reviewed the technical nuances, clinical outcomes, and long-term durability of each technique, incorporating findings from recent and historical studies. Also, we'd like to present two case reports from our clinic showing the application of the David procedure.
Results: The David procedure involves complete excision of the aortic root and reimplantation of the native aortic valve within a Dacron graft. It offers superior long-term durability and lower reoperation rates, particularly in younger patients and those with connective tissue disorders. In contrast, the Yacoub procedure entails partial root resection and remodeling with preservation of the sinuses of Valsalva, making it a viable option for older patients or those with isolated root dilation.
Conclusions: Both the David and Yacoub procedures are advanced techniques for aortic root replacement, each with unique advantages and challenges. The David procedure, with its excellent durability, has consistently delivered successful outcomes. It is especially beneficial for younger patients and those with connective tissue disorders, supporting its role as a preferred approach for long-term outcomes in this population.
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