Ljubljana experience
At the University Hospital Center Ljubljana (Slovenia, EU), 16 patients (12 male) with isolated aortic root aneurysm were selected for minimally invasive David procedure over a 4-year period (Figure 1). No Ethics Committee approval was required given that this analysis was retrospective and anonymized. All patients were consented for the surgery and use of their anonymized data for future research and publications.
Concomitant aortic valve repair was performed in 8 out of 16 (50%) patients and coronary artery bypass graft (saphenous venous graft to right coronary artery) in one patient. In most cases, straight 30-32 mm Dacron graft (Gelweave) was used. Technique was also modified by performing wrapping of distal anastomosis in 10 out of 16 patients as, in our experience, it was helpful in achieving better hemostasis. No conversion to full sternotomy or re-exploration due to bleeding was observed. 30-day postoperative mortality and stroke were 0%.