[Valve replacement in severe aortic regurgitation following valve sparing operation with David's technique]

The aortic valve sparing operation is of great interest in the treatment of severe aortic insufficiency caused by annulus enlargement in aortic annuloectasia. If valve leaflets are normal, and we want to prevent complications derived from valve prosthesis and chronic anticoagulation, techniques like David s for valve preserving surgery will be performed. Although long-term results of these techniques are usually good, in some cases, like in the one we are dealing with here fibrosis is produced in the native valve, which evolves into a severe aortic insufficiency needing reoperation. We hereby describe the time related events of aortic valve deterioration, when the reintervention was indicated, and how the surgery was performed.