How to perform valve sparing reimplantation in a tricuspid aortic valve

Aortic valve (AV) sparing procedures are increasingly being used to treat aortic root pathologies. Reimplantation of the aortic valve, first described by Dr Tirone David, is a technically demanding procedure whose long-term results are critically dependent on perfect intraoperative restoration of valve anatomy and function. There exists significant variation in how this procedure is performed by different surgeons, which is likely contributory to the heterogeneity in reported results. We describe a systematic approach to aortic valve reimplantation procedure focusing on key technical aspects.