The Tirone David Operation is a complex surgical procedure. During Valve Sparing Root Replacement (David Procedure), the enlarged ascending aorta is replaced by a graft (artificial tube) but the patient's aortic valve is preserved and sutured inside the graft. By preserving the native aortic valve, patients avoid the need for lifelong anticoagulation therapy (Coumadin) or the risk of bioprosthesis failure. We will discuss with you the most appropriate treatment or surgery for your individual condition and discuss the benefits and risks of surgery. We will evaluate your risk of aortic dissection and measure the diameter of your aorta when deciding if you are a candidate for surgery.