Right coronary sinus fixation through a right ventriculotomy for David's procedure.
A key element to the success of aortic valve reimplantation (David's procedure) is the position of the aortic annulus in the Dacron tube (DuPont, Wilmington, DE). The variable level of the right ventricular insertion can cause technical difficulties, especially when the right ventricular insertion occurs above the aortic annulus. To resolve this issue, a technical adjunct is described using a right superior ventriculotomy. This technique allows perfect aortic annulus containment, avoids any rocking motion of the margin of the right coronary cusp, and affords the procedure better long-term durability.
Labrousse
Louis
L
Department of Cardiovascular Surgery, Hôpital Haut-Lévèque, Bordeaux Heart University Hospital, Bordeaux-Pessac, France. louis.labrousse@chu-bordeaux.fr
Montaudon
Michel
M
Black
Sheila
S
Deville
Claude
C
D017545:Aortic Aneurysm, Thoracic / Q000000981:diagnostic imaging / Q000601:surgery*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation; D054326:Coronary Sinus / Q000000981:diagnostic imaging / Q000601:surgery*; D017548:Echocardiography, Transesophageal; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000000981:diagnostic imaging; D012092:Replantation / Q000379:methods*; D013536:Suture Techniques