Adjustment of aortic annulus size during David re-implantation (how to do it).

Stability of the aortic annulus is a key factor in achieving long-term durability of the aortic valve re-implantation. We propose a new method of sub-annular fixation of the root prosthesis, enabling post-procedural transesophageal echocardiography (TEE)-guided adjustment of the aortic annulus dimensions.