Key result
Elective David I root replacement yields ~92% survival, far outperforming acute dissection repairs.
Why the study?
Regional data on valve-sparing root replacement outcomes within emerging surgical programs remain limited.
What are the survival and valve durability outcomes of the David I valve-sparing aortic root reimplantation in a South Indian cohort?
Cohort (n=25)
No
What are the survival and valve durability outcomes of the David I valve-sparing aortic root reimplantation in a South Indian cohort?
Standardized straight-graft David I valve-sparing root replacement achieves high overall survival (92.0%) and elective valve durability (90.9%) in an emerging South Indian surgical program, though high rates of late moderate aortic regurgitation in acute Type A dissection (75.0%) highlight the need for careful patient selection and serial echocardiographic surveillance.
Answers are grounded in this paper and cite their sources.
Hypothesis-generating for David I reimplantation in South Indian patients; prospective studies needed to confirm durability and surveillance.
Regional data on valve-sparing root replacement (VSRR) outcomes within emerging surgical programs remain limited. We report our institutional experience using the David I procedure from a tertiary care center in South India. We retrospectively evaluated 25 consecutive patients who underwent David I VSRR between January 2017 and December 2022. Endpoints included 30-day mortality, overall survival, and valve durability [defined as freedom from ≥ moderate aortic regurgitation (AR)]. The cohort (median age 50 years, 72% men) comprised 16.0% (4/25) acute Type A dissections (ATAAD). Baseline anatomy included two bicuspid and one quadricuspid valve. Intentional cusp repairs were required in 20.0% (5/25). Over a cumulative follow-up of 120 patient-years, overall survival was 92.0%. Kaplan–Meier freedom from ≥ moderate AR in the elective cohort (n = 21) was 90.9% (95% confidence interval [CI] 73.9%- 100.0%), whereas 3 of 4 emergency patients (75.0%) developed asymptomatic moderate AR during follow-up (Fisher's exact p = 0.007). Paired postoperative comparisons demonstrated improvement in functional class (p < 0.001). Standardized straight-graft David I technique provides reliable early survival for valve-sparing root replacement in a regional setting. Late AR in ATAAD (3/4) warrants cautious patient selection and serial echo surveillance.
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Sathanantham et al. (2026) conducted a cohort in Aortic root disease undergoing David I valve-sparing root replacement (including 16% acute Type A aortic dissection) (n=25). David I valve-sparing aortic root reimplantation (straight-graft technique) was evaluated on 30-day mortality, overall survival, and valve durability (freedom from ≥ moderate aortic regurgitation) (95% CI 73.9%-100.0%, p=0.007). David I valve-sparing root replacement yielded 92.0% overall survival and 90.9% freedom from ≥moderate AR in elective cases vs 25.0% in acute dissection (p=0.007).
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