Right coronary sinus fixation through a right ventriculotomy for David's procedure

Area of Science:

• Cardiac Surgery
• Aortic Valve Repair
• Surgical Techniques

Background:

• The success of David's procedure hinges on aortic annulus placement within the graft.
• Variations in right ventricular insertion can complicate the procedure, particularly when above the annulus.

Purpose of the Study:

• To present a technical adjunct for optimizing aortic annulus positioning in David's procedure.
• To address challenges associated with right ventricular insertion above the aortic annulus.

Main Methods:

• Description of a technical adjunct utilizing a right superior ventriculotomy.
• Application of the technique during aortic valve reimplantation (David's procedure).

Main Results:

• The described technique facilitates precise aortic annulus containment.
• It effectively prevents rocking of the right coronary cusp margin.
• Improved long-term durability of the aortic valve reimplantation is achieved.

Conclusions:

• A right superior ventriculotomy is a valuable adjunct for David's procedure.
• This technique enhances surgical precision and procedural durability.
• It offers a solution for managing challenging right ventricular insertion levels.