[Current status and reflections on David procedure in the management of acute type A aortic dissection involving the...

Acute type A aortic dissection (ATAAD) involves complex pathology in aortic root, and appropriate surgical strategies are crucial to clinical outcomes. Recently, with significant improvements in the safety and short-term efficacy of ATAAD surgical strategies, maximizing the elimination of aortic root dissection and preserving well-functioning aortic valves during emergency surgery is directly related to the long-term survival quality of patients. David procedure is an effective aortic valve repair technique which has shown satisfactory long-term outcome in patients with aortic root aneurysm and aortic regurgitation. Due to its ability to eliminate aortic root dissection, preserve the aortic valve, and facilitate hemostasis, David procedure plays a significant role in the management of ATAAD aortic root pathology and has great potential for broader application. This article elaborates on the characteristics of ATAAD, treatment strategies, the technical features of David procedure, and progress in clinical practices, aiming to provide a reference for the rational application of David procedure in ATAAD and further improve the long-term efficacy and quality of life for patients with ATAAD.