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Why Choose Penn Medicine

Cardiac surgeons within the Aortic Center have unmatched expertise repairing aortic aneurysms that exist at the aortic root (where the aorta connects with the heart). As a high-volume center — the most active in the region — we routinely perform technically challenging procedures like aortic root replacement. Our surgeons are renowned for using complex surgeries to help very high-risk patients.

Valve-Sparing Aortic Root Replacement Overview 

The aortic valve separates the heart from the rest of the ascending aorta at the aortic root. When thoracic aortic aneurysms occur at the aortic root, the aorta can widen, causing the aortic valve to leak and put the patient at risk for developing an aortic dissection.

To preserve the patient’s own aortic valve (native valve), Penn cardiac surgeons offer valve-sparing aortic root replacement, also known as the David Procedure. To perform the procedure, your surgeon works closely with a specially trained cardiac anesthesiologist to place you into a deep and comfortable sleep. Next, your surgeon:

  • Makes an incision in your chest and places you on a heart bypass machine, which takes over the function of the heart and lungs during surgery.
  • Places a clamp across the aorta and surgically removes the enlarged section of the aorta, including the valve. 
  • Removes the native valve from the diseased aorta, then sews it inside a synthetic tube (graft) that will act as the replacement aorta.
  • Sews the valve-in-graft to the heart, then connects the upper part of the graft to the remaining aorta.

Benefits of Aortic Root Surgery 

Whenever possible, Penn cardiac surgeons strive to keep a patient’s native valve intact because it has better durability than an artificial valve. Reusing a patient’s own aortic valve helps avoid lifelong anticoagulation (blood-thinning) therapy, which is necessary with a replacement valve.

In some situations, however, keeping a native valve isn’t possible. When this is the case, our surgeons provide leading-edge aortic valve surgery.

Cardiac Rehabilitation After the David Procedure

To improve your recovery after valve-sparing aortic root replacement, your cardiac surgeon may recommend cardiac rehabilitation. You will receive exercise, nutrition, education and support by a team of cardiac rehab specialists in an outpatient center. Learn more about cardiac rehab.

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