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May 1964

Inexorable Aortic Stenosis: Surgical Palliation and Restenosis After Blind Transventricular Aortic Commissurotomy

Author Affiliations


From the departments of medicine and surgery, University of Washington School of Medicine.

Arch Intern Med. 1964;113(5):706-710. doi:10.1001/archinte.1964.00280110086017

Aortic valvular stenosis has been amenable to surgery since the development of blind instrumental commissurotomy and dilatation.1-3 Despite the significant mortality of transventricular or transaortic commissurotomy, the surgical risks of these "blind" procedures were accepted because of the poor prognosis of patients with advanced, symptomatic aortic stenosis.4,5

With the use of cardiopulmonary bypass techniques, open-heart aortic valvuloplasty and total valve replacement have supplanted the earlier blind procedures.6,7 The technical advantage of the direct visual approach appears to be a major contribution to the management of patients with this lesion, since the heavily calcified, immobile, rock-like valve was often refractory to blind instrumental dilatation.

In this report the late results of transventricular aortic commissurotomy are described in terms of symptomatic improvement, postoperative survival, and hemodynamic responses. These data should be of value for comparison with late results following newer procedures.

Material and Methods  Thirty out of 34 patients

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