Good morning friends and family! Welcome back to another week of Topic Tuesday where we share some brief educational material about the heart, aorta, and general health. Last week, my good friend Duc talked to you about aneurysm surveillance.
Here's a challenge - do you remember how many times greater than the size of a normal aorta an aneurysm was?
A - 1.5 x greater
B - 2.0 x greater
C - 3.0 x greater
D - 4.0 x greater
Comment your answer down below but no peeking :)
For this week's post, I wanted us to start talking about different operations that can help treat aortic aneurysms, starting with the Valve-Sparing Aortic Root Replacement, more commonly known as the David Procedure after the surgeon who invented it.
Dr. Tirone E David
This link from Columbia University helps share lots of great graphics from the procedure - https://columbiasurgery.org/conditions-and-treatments/valve-sparing-aortic-root-replacement-david-procedure
The David Procedure is used to treat aortic aneurysms that occur in the root or the part of the aorta that directly connects to the aortic valve and heart. Perhaps the greatest benefit of the procedure is that the native aortic valve of the patient is "preserved" and later sutured back directly to the graft after removing the diseased section of the aorta.
During surgery, your aorta will be cross-clamped while you go on the heart-lung machine, and the surgical team will carefully dissect out the aneurysm and size a piece of prosthetic graft the same size as the aneurysm tissue which was removed. When removing the aneurysm tissue, your coronary vessels will be carefully removed as small "buttons" to later be reimplanted.
The sized graft will then carefully be sutured to your native aortic valve with care to ensure the leaflets of the valve are not damaged or stretched out. Next, two small holes will be punched into the graft to reattach those coronary buttons from before.
At the end of the surgery, you will have a remodeled graft aortic root with preservation of your native aortic valve and coronary vessels. Keeping a natural aortic valve has many benefits over receiving a prosthetic valve, including avoiding the need for life long blood thinners with mechanical valves or the risk of bioprosthetic valve degeneration.
The David Procedure is an option in patients with aortic root aneurysms who have viable aortic valves with minimal calcification or regurgitation. However, for patients with aortic root aneurysms and concurrent aortic valve disease, another surgery called the "Bentall Procedure" may be a better option. We will discuss it next week!
Thank you for joining us today for another Topic Tuesday. We hope you have an incredible week, and until next time, remember to always #ThinkAorta!
Your friend,
AA
Comments