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Related Experiment Video

Updated: Apr 17, 2026

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

A modified David V: Technique and outcomes from a large single centre experience.

Robert Fleck¹, Melissa G Medina¹, Christopher K Mehta¹

¹Division of Cardiac Surgery, Northwestern University Feinberg School of Medicine Bluhm Cardiovascular Institute, Chicago, IL 60611, USA.

Asian Cardiovascular & Thoracic Annals

|April 16, 2026

Summary

This study shows that a modified David V valve-sparing aortic root replacement technique offers excellent survival and freedom from reoperation rates. Meticulous surgical technique and careful valve assessment are key to successful outcomes in aortic root surgery.

Keywords:

Aortic aneurysm David V David procedure Stanford modification aortic surgery reimplantation technique valve sparing aortic root replacement

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Published on: June 8, 2022

Area of Science:

Cardiovascular Surgery
Thoracic Surgery
Aortic Surgery

Background:

Composite valve-graft replacement is standard for aortic root replacement.
Valve-sparing aortic root replacement (VSARR) preserves the native aortic valve.
Refinements in VSARR techniques, including remodeling and reimplantation, have improved outcomes.

Purpose of the Study:

To describe the technical steps and outcomes of a modified David V procedure for VSARR.
To evaluate the early and midterm results of this adapted Stanford modification.

Main Methods:

Retrospective review of 185 patients who underwent adapted Stanford modification VSARR between November 2007 and March 2025.
Data collected from a prospectively maintained institutional database.
Analysis of patient demographics, procedural details, and clinical outcomes.

Main Results:

Mean patient age was 47.6 years, with 81% males.
Low mortality (0.5%) and no 30-day reinterventions.
Excellent midterm results with 1, 5, and 10-year survival rates of 99%, 98%, and 92%, respectively.
High freedom from aortic valve or re-operation rates: 99% (1 year), 97% (5 years), and 94% (10 years).
No cases of greater than moderate aortic insufficiency on early echocardiographic follow-up.

Conclusions:

Meticulous surgical technique and thorough valve assessment are crucial in VSARR.
The modified David V procedure demonstrates favorable early and midterm outcomes.
Graft type and size appear less critical than surgical precision in VSARR.