Valve-Sparing Aortic Root Replacement (David Procedure)

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You may be visiting your doctor for mild chest pain. Or, you're seeing them for a routine visit. When they check your chest with an x-ray, the doctor finds an aortic root aneurysm. Although you may be feeling fine, this aneurysm can lead to an emergency.

A valve-sparing aortic root replacement, also called the David procedure, repairs aneurysms at the aortic root. We replace your aorta at the aortic root. But we keep your natural heart valve in place. That prevents you from needing a valve replacement procedure later on.

UVA Health's Aortic & Aneurysm Expertise

At our Aortic Center, our expert heart and vascular team has deep experience and training in perform procedures like valve-sparing aortic root replacement. We’ve received special recognition for our experienced, high-quality heart care, especially in treating aortic conditions, valve conditions, and for performing bypass surgery.

Treatment With Valve-Sparing Aortic Root Replacement

The aortic root is where your aorta (your largest blood vessel) connects to your heart. Aneurysms can happen anywhere along blood vessels, like at the aortic root. Aneurysms can tear or rupture over time, which can be life-threatening.

There’s a valve at the aortic root (called the aortic valve) between your heart and the aorta. It keeps blood going into the aorta from flowing back into your heart. An aneurysm at the aortic root also keeps that valve from working correctly.

During the David procedure, we replace your aorta to remove the aneurysm. We use a special synthetic tube called a graft. But we keep your natural aortic valve.

There are important benefits to keeping your natural aortic valve in place. Artificial valves are available, but they need replacing every 10-15 years. Your natural aortic valve is stronger. Keeping your natural valve means you won’t need surgery later to replace a worn-out artificial valve.

Getting an artificial valve also means you'll need anti-clotting medicine (blood thinners) for the rest of your life. With a David procedure, you won’t need this medicine.

Am I a Good Candidate for a David Procedure?

Conditions that prevent you from being a candidate for valve-sparing root replacement include:

  • The valve is damaged or doesn’t work properly
  • There’s calcium build-up in the valve (calcification), which makes it stiff

Our valve disease experts can recommend other treatment options if your aortic valve won't work with a David procedure.

What to Expect from the David Procedures

During the procedure, we’ll:

  • Open your chest to get to your heart and aorta
  • Put you on a machine that works as your heart and lungs during the surgery
  • Remove the affected part of the aorta
  • Connect the valve to the synthetic tube that replaces your aortic root
  • Connect the tube first to the heart, then to the rest of your aorta

Full recovery usually takes about 2 months.