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Aortic Regurgitation I: Introduction

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IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...

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Related Experiment Video

Updated: Aug 5, 2025

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Twenty-five year experience with aortic valve-sparing root replacement in a single teaching center.

Juri Sromicki¹, Mathias Van Hemelrijck¹, Martin O Schmiady¹

¹Department of Cardiac Surgery, University Zurich and University Hospital Zurich, Zurich, Switzerland.

Frontiers in Cardiovascular Medicine

|March 27, 2023

Summary

The David operation for aortic valve-sparing root replacement (AVSRR) shows excellent outcomes, even in centers without extensive AVSRR programs. This complex procedure offers favorable long-term results for aortic root replacement, particularly for younger patients.

Keywords:

David operation and David procedure aortic aneurysm (AA)aortic regurgitation (AR)aortic root reimplantation aortic valve sparing surgery david operation david procedure

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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

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Last Updated: Aug 5, 2025

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Published on: December 11, 2017

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

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Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

Published on: March 26, 2018

Area of Science:

Cardiovascular Surgery
Aortic Valve Disease
Surgical Outcomes

Background:

Aortic valve-sparing root replacement (AVSRR) is a complex surgical technique.
It is an attractive option for aortic root replacement, especially in younger individuals.
The David operation is a specific AVSRR procedure.

Purpose of the Study:

To evaluate the long-term results of the David operation for AVSRR.
To analyze outcomes in a teaching institution that does not specialize in AVSRR.
To assess the procedure's efficacy over a 25-year period.

Main Methods:

A retrospective analysis of 131 patients undergoing the David operation between 1996 and 2019.
Data collected from electronic medical records and direct patient/physician follow-up.
Analysis included perioperative outcomes and long-term reoperation rates.

Main Results:

30-day mortality was 2%; 97% had good aortic regurgitation post-surgery.
At 10-year follow-up, 12% required reoperation for root-related complications.
Reoperation-free survival was 87.0% at 10 years; bicuspid valves or severe regurgitation did not impact survival, but larger LV end-diastolic diameter did.

Conclusions:

The David operation can achieve excellent perioperative and 10-year outcomes.
These results are achievable in centers that are not high-volume AVSRR programs.
The procedure is a viable option for aortic root repair with good long-term results.