Valve-sparing aortic root replacement: the inclusion (David) technique

Presentation of the aortic valve reimplantation technique (David I): Removal of the diseased ascending aorta, excision of the coronary ostia and resection of aortic sinuses up to a rim of 2-3 mm of aortic wall as well as extensive external dissection and mobilization of the aortic root; placement of horizontal sutures placed circumferentially through the annulus underneath the valve; anchoring a Dacron-graft in the aortic root with the sutures; fixation of commissures high into the tube graft; reimplantation of the sinuses into the graft with a blood-tight running suture line; reimplantation of coronary buttons; establishment of distal aortic anastomosis.