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Ann Thorac Surg 2003;76:1751-1753
© 2003 The Society of Thoracic Surgeons

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How to do it

Sizing for modified david’s reimplantation procedure

^a Department of Thoracic and Cardiovascular Surgery, Center for Aortic Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio, USA

Accepted for publication February 14, 2003.

^* Address reprint requests to Dr Svensson, Center for Aortic Surgery, Marfan Syndrome and Connective Tissue Disorders Clinic, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Desk F25, Cleveland, OH, USA 44195
e-mail: svenssl{at}ccf.org

The problem of sizing the graft, annulus, and left ventricular outflow tract for the David reimplantation type of aortic valve preserving procedure remains a concern, particularly in patients with Marfan syndrome. To resolve this issue, a modified method used in over 20 patients is described of doing the repair around a Hegar’s dilator. In essence, the size chosen is according to the patient’s normalized annular size based on body surface area. This technique also creates a neosinus in the root.

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