David's operation, developed by the famous cardiac surgeon Tyrone David, is an advanced surgical technique in which aortic root is prosthetic with the preservation of its own aortic valve.
During surgery, the damaged part of the aorta is removed and replaced with a synthetic graft, but the patient's aortic valve is preserved. The aortic valve is sewn in the right place in the graft. In this case, the patient must have a healthy valve. After a visual assessment of the condition of the aortic root and aortic valve, the sinuses of Valsalva are resected, leaving a "side" of 5-6 mm. The mouths of the coronary arteries are distinguished at the sites. Thus, after the isolation, the aortic root represents the fibrous ring of the aortic valve and the valve of the aortic valve with commissures..
The next step is to measure the size of the aortic root: the diameter of the fibrous ring of the aortic valve using standard diameter meters, and the distance from the base of the aortic root to the upper edge of each commissure is measured using a lined scalpel handle. For reimplantation of the aortic valve, both straight prostheses and prostheses with artificial sinuses of the Valsalva are used. The fibrous ring of the aortic valve is stitched with separate U-shaped sutures on the gaskets from the inside to the outside under the valves of the aortic valve. The holders of the commissures are placed inside the prosthesis, and its base is stitched with fixing sutures to the fibrous ring. The sutures are tied and the prosthesis is fixed to the aortoventricular joint.