{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T01:41:26Z","timestamp":1790559686220,"version":"4.1.0"},"reference-count":21,"publisher":"Georg Thieme Verlag KG","issue":"04","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Thorac Cardiovasc Surg"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>\n            Introduction\u2003Aortic valve-sparing root replacement (David's procedure) is an especially appealing treatment option for young patients. Here, we present the short-, mid, and long-term outcomes of this operation in adolescent patients.<\/jats:p><jats:p>\n            Methods\u2003Between September 1994 and March 2014, 29 patients aged 6 to 21 years underwent the David-I procedure at our center. We conducted a retrospective study with follow-up.<\/jats:p><jats:p>\n            Results\u2003The mean age was 16.8\u2009\u00b1\u20093.4 years and 90% (n\u2009=\u200926) were male. Marfan's syndrome was present in 86% (n\u2009=\u200925) of cases. Ninety-seven percent (n\u2009=\u200928) of cases were performed electively, and one case (3%) was performed emergently for acute aortic dissection type A. There were no early perioperative deaths (0%). Follow-up, which was completed on 100% of patients, comprised a total of 394 patient years and a mean follow-up time of 13.6\u2009\u00b1\u20095.4 years. The estimates for survival at 1, 5, and 10 years after initial surgery were 100, 97, and 93%, respectively. During follow-up, there were four (14%) late deaths and five (17%) aortic valve-related reoperations. The 1-, 5-, and 10-year estimates for freedom from valve-related reoperation were 100, 86, and 83%, respectively. The perioperative mortality for these five reoperations was 0%.<\/jats:p><jats:p>\n            Discussion\u2003Aortic valve\u2013sparing root replacement can be performed in adolescents with a very low perioperative risk. Long-term survival seems to be affected by connective tissue diseases.<\/jats:p>","DOI":"10.1055\/s-0039-1693654","type":"journal-article","created":{"date-parts":[[2019,7,22]],"date-time":"2019-07-22T22:37:56Z","timestamp":1563835076000},"page":"308-313","source":"Crossref","is-referenced-by-count":5,"title":["Aortic Valve\u2013Sparing Root Replacement (David I Procedure) in Adolescents: Long-Term Outcome"],"prefix":"10.1055","volume":"69","author":[{"given":"Erik","family":"Beckmann","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andreas","family":"Martens","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heike","family":"Krueger","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilhelm","family":"Korte","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Kaufeld","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Haverich","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malakh Lal","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2019,7,22]]},"reference":[{"issue":"04","key":"ref1","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/S0022-5223(19)34942-6","article-title":"An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta","volume":"103","author":"T E David","year":"1992","journal-title":"J Thorac Cardiovasc Surg"},{"issue":"01","key":"ref2","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1067\/mtc.2001.112935","article-title":"Results of aortic valve-sparing operations","volume":"122","author":"T E David","year":"2001","journal-title":"J Thorac Cardiovasc 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Cardiothorac Surg"},{"issue":"02","key":"ref14","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1016\/j.athoracsur.2011.12.097","article-title":"Valve-sparing aortic root reconstruction in children, teenagers, and young adults","volume":"94","author":"J S Tweddell","year":"2012","journal-title":"Ann Thorac Surg"},{"issue":"01","key":"ref15","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1161\/CIRCULATIONAHA.114.009835","article-title":"Accelerated degeneration of a bovine pericardial bioprosthetic aortic valve in children and young adults","volume":"130","author":"S F Saleeb","year":"2014","journal-title":"Circulation"},{"key":"ref16","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1161\/CIRCULATIONAHA.110.011973","article-title":"Reoperation of left heart valve bioprostheses according to age at implantation","volume":"124","author":"V 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Surg"},{"issue":"17","key":"ref21","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.1016\/j.jcin.2018.06.044","article-title":"The learning curve and annual procedure volume standards for optimum outcomes of transcatheter aortic vavle replacement: findings from an international registry","volume":"11","author":"A WA Wassef","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"issue":"05","key":"ref22","doi-asserted-by":"crossref","first-page":"1479","DOI":"10.1016\/j.athoracsur.2017.04.005","article-title":"Risk factors for late aortic valve dysfunction after David V valve-sparing root replacement","volume":"104","author":"J Esaki","year":"2017","journal-title":"Ann Thorac Surg"},{"issue":"06","key":"ref23","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1002\/mgg3.489","article-title":"Survival, causes of death, and cardiovascular events in patients with Marfan syndrome","volume":"6","author":"T T Vanem","year":"2018","journal-title":"Mol Genet Genomic Med"}],"container-title":["The Thoracic and Cardiovascular 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