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Long Term Results After Aortic Valve-sparing (David) Operation In Patients With Bicuspid Aortic Valve
Doreen Richardt, Ulrich Stierle, Hans-Hinrich Sievers.
University clinic of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.

OBJECTIVE: Aortic valve-sparing reimplantion operation (David) is more and more used in patients with aortic root aneurysm and unimpaired cusps. Even in patients with bicuspid aortic valves (BAV) David's procedure is feasible, despite there are little long term data so far.
METHODS: We analyzed our long term echocardiographic data in patients with BAV and David's procedure at early and long term follow up examination (FU).
RESULTS: In the years 1994 to 2010, 30 patients with BAV underwent David's procedure. There has been no in-hospital or late death. Four patients (13%) had to be reoperated after 10.00 ± 4.74 years (Range 5.49 - 17.06 years) due to aortic insufficiency or endocarditis.
CONCLUSIONS: Although mean AI grade increased significantly, the clinical result is less than AI I° after a mean long term FU of about five and up to 18 years. In patients with BAV and aortic root aneurysm David's procedure offers reliable therapeutic options with very promising long term results.

data are shown mean +- SD, *=p<0.05
Early FU (n=23)Long term FU (n=28)p-value (Early FU vs. Long term FU)
FU (years)0.06±0.034.99±3.44
FU Range (years)0.02-0.120.67-18.07
Pmax (mmHg)20.02±12.7621.38±12.040,118
Pmean (mmHg)12.41±8.3112.45±9.250,701
Mean AI grade0.261±0.3650.690±0.8060,018*

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