[3][4] The valve-sparing aortic root replacement allows for direct narrowing of enlarged aortas, which change the fluid dynamics of outbound blood from the heart, while preserving the natural tissues of the aortic valve, which means the patient does not have to rely on anticoagulants.
Common features of both techniques of the replacement process are the clamping of the aorta and the use of a length of Dacron tube (also known as an "aortic graft"), typically 5 cm, to constrict the aortic root to the normal diameter, while the patient is cooled to 20°C and placed on life support.
[6][7] Established by Tirone E. David and Christopher Feindel at the Toronto General Hospital in 2007,[8] this technique differs in the shape of the Dacron tube's end, which here is a ring with a flat edge, and its location, with the sinotubular junction "inserted" into the tube.
[9][10][11] A 2023 literature review of David method patient outcomes after 2010 found that the chances of complications such as endocarditis and stroke, were reduced to 0.3%, while survival rates were 99% within a year and 89% within a decade afterward.
The most common reason for follow-up (typically needed in 5 years) was minor chest bleeding, reported by 5.4% of patients.