Leaders in Valvuloplasty Around the World

  • Takashi KuniharaEmail author
  • Shuichiro Takanashi


Professor Tirone E. David (Fig. 39.1) is a giant star among cardiac surgeons, and it is no exaggeration to say that every surgeon knows his name. For a cardiac surgeon, I think there can be nothing more honorable than having one’s own name represent the name of a surgical procedure. As everyone knows, the “David procedure”, valve-sparing aortic root reconstruction, is a surgery in which the three Valsalva sinuses are excised and the crown-shaped aortic annulus is enclosed within a vascular graft, and it can be said that this represents Prof. David’s aggressive approach to new cardiovascular surgery and his superior surgical technique that enables it. In the early stage of development, a straight graft without the Valsalva sinus was used (David-I) [1] with the cusp free margin length as its diameter. However, in the latest technique, it has been changed to use a larger graft creating a Valsalva sinus (David-V). Previously, the David procedure could only be performed by Prof. David, but I appreciate his great contribution to the standardization and popularization of this procedure by analyzing anatomical theory and proving excellent long-term results.


  1. 1.
    David TE, Feindel CM. An aortic valve-sparing operation for patients with aortic incompetence and aneurysm of the ascending aorta. J Thorac Cardiovasc Surg. 1992;103:617–21.PubMedGoogle Scholar
  2. 2.
    Bavaria JE, Fukuhara S, Desai ND. Thoracic aortic surgery enters the era of big data. Eur J Cardiothorac Surg. 2017;52:499–500.CrossRefGoogle Scholar

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© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.Department of Cardiac SurgeryThe Jikei University School of MedicineTokyoJapan
  2. 2.Cardiovascular SurgerySakakibara Heart InstituteFuchuJapan

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