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Related Experiment Video

Updated: May 4, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
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Valve-sparing aortic root replacement: the inclusion (David) technique.

Klaus Kallenbach1, Matthias Karck, Axel Haverich

  • 1Department of Thoracic and Cardiovascular Surgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.

Multimedia Manual of Cardiothoracic Surgery : MMCTS
|January 14, 2014
PubMed
Summary

The David I technique for aortic valve reimplantation involves detailed steps for reconstructing the aortic root and reattaching coronary arteries. This surgical method addresses complex aortic root pathologies, aiming for successful valve and aorta repair.

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Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Aortic Surgery

Background:

  • Aortic root aneurysms and dissections often require complex surgical repair.
  • The David I procedure is a specific technique for aortic valve-sparing root replacement.
  • Reimplantation of the aortic valve and coronary arteries is crucial for maintaining cardiac function.

Purpose of the Study:

  • To present the detailed surgical steps of the David I aortic valve reimplantation technique.
  • To highlight key aspects of aortic root reconstruction and coronary artery reattachment.
  • To provide a procedural overview for surgeons performing aortic valve-sparing root replacement.

Main Methods:

  • Removal of diseased ascending aorta and aortic sinuses.
  • Circumferential suturing at the aortic annulus for graft anchoring.
  • Reimplantation of aortic sinuses and coronary buttons into a Dacron graft.
  • Creation of distal aortic anastomosis.

Main Results:

  • The technique involves precise dissection and mobilization of the aortic root.
  • Horizontal sutures anchor the Dacron graft securely in the aortic root.
  • Commissures are fixed high within the graft, and sinuses are reimplanted with a blood-tight suture line.
  • Coronary buttons are reimplanted, and the distal anastomosis is established.

Conclusions:

  • The David I technique offers a method for aortic valve reimplantation.
  • Careful execution of each step, including sinus and coronary reimplantation, is essential.
  • This procedure aims to repair the aortic root while preserving the native aortic valve.