cp. picture series: fig. 1a | fig. 1b | fig. 1c | fig. 1d | fig. 1e | fig. 3a
A reconstruction of the aortic valve is considered a therapy when the valve's function is insufficent (closure leakage) but morphologically intact.
The big advantage of this procedure is that the patient's aortic valve (which is superior in haemodynamics to every artificial valve) can be structurally preserved. Therefore there is no need for oral anticoagulation drugs.
The operative procedure includes resection of all aortic wall parts including the sinus valsalvae - but preserving the valvous- and anullous parts. The junctions of the coronoray arteries are isolates as so called 'buttons'.
The whole valve-apparatus is now implanted within a pipe prosthesis - with or without a developed sinus. The annulus is stabilized by U-sutures (procedure after David).In context of the procedure after Yacoub, the valve is anastomized with a pipe-prosthesis which is adjusted to the sinus. If necessary the annulus is strengthened by teflon strips.In both procedures the coronary-buttons are anastomized with the prosthesis. With the help of a ECG the postoperative results of both procedures are well proved.Younger patients benefit from this procedures in particular, longterm results have to be awaited.(You will find further information on my website www.Ennker.de)