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January 1960

Surgical Correction of Aortic Regurgitation

Author Affiliations

Dr. Bailey was formerly with Hahnemann Medical College and Hospital; present address New York Medical College, Flower and Fifth Avenue Hospitals, New York.; Former Director, Bailey Thoracic Clinic; Chief of Cardiopulmonary Division, Einstein Medical Center; Present Chairman, Department of Surgery, New York Medical College; Director of Surgery, Flower and Fifth Avenue, Metropolitan and Bird S. Coler Hospitals, New York (Dr. Bailey). Former Resident Surgeon in Cardiovascular Surgery, Albert Einstein Medical Center (Dr. Zimmerman). Director, Cardiac Surgical Research, Mary Bailey Foundation for Heart and Great Vessel Research (Dr. Blanco). Former Fellow in Thoracic Surgery, Hahnemann Hospital of Philadelphia; Present active duty, National Heart Institute of National Institutes of Health, U.S. Public Health Service (Dr. Sparger).

AMA Arch Surg. 1960;80(1):16-30. doi:10.1001/archsurg.1960.01290180018003

Aortic regurgitation hemodynamically amounts essentially to an aorticoventricular fistula. While it is not strictly accurate to classify this condition as one of the forms of arteriovenous fistula, the clinicopathological analogies implied in such a connotation may be very helpful in understanding the notoriously rather extreme variations in the clinical course of aortic insufficiency. Thus it may enable one to appreciate readily that a small to moderate-sized fistula might be compatible with a prolonged life of normal activity while a larger one would initiate a rapidly progressive "downhill" course. This would tend to explain the differing attitudes of cardiologists with respect to the disease. Some of them consider it to be a relatively benign lesion even in the face of progressive (and sometimes extreme) enlargement of the heart, while others are most disturbed by the mere finding of a basal diastolic murmur and a low diastolic blood pressure level, frequently in

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