Results of Surgical Treatment of Aortic Stenosis

Baker, Charles; Somerville, Jane

doi:10.1136/bmj.1.5377.197

Cited by 15 publications

(7 citation statements)

References 11 publications

(5 reference statements)

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“…This is borne out by general experience. Baker and Somerville (1964) found the aortic valve calcified in all the 89 cases over. 40 who had aortic valvotomy and in 34 of the 63 who were 40 or under.…”

Section: Bicuspid Aortic Valves and Aortic Stenosismentioning

confidence: 85%

“…They are even more common in congenital aortic stenosis, about 57 per cent (Campbell, see Table VI; Baker and Somerville, 1964;Hohn et al, 1965), and most common (74%) in aortic stenosis associated with coarctation of the aorta (Smith and Matthews, 1955). Donald Ross (1967, personal communication) found that the valve was bicuspid in 82 of the last 100 where he had drawn a picture.…”

mentioning

confidence: 99%

“…Pomerance (1967) found that atheroma of the anterior mitral cusp and calcification of the mitral valve ring and of the aortic valve cusps were the three main changes that were directly associated with ageing. (Table VI) and Baker and Somerville (1964). men (this might be associated with the much higher male incidence of bicuspid aortic valves).…”

mentioning

confidence: 99%

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Calcific aortic stenosis and congenital bicuspid aortic valves.

Campbell¹

1968

Heart

108

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Section: Bicuspid Aortic Valves and Aortic Stenosismentioning

confidence: 85%

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confidence: 99%

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Calcific aortic stenosis and congenital bicuspid aortic valves.

Campbell¹

1968

Heart

108

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“…9 Postoperative cardiac catheterisation with aortography and left ventriculography was performed two to seven years later in three patients. The degree of aortic regurgitation was assessed according to Sellers et al.,'0 and graded from 1 to 4.…”

Section: Methodsmentioning

confidence: 99%

Aorto-left ventricular communication after closure. Late postoperative problems.

Serino¹,

Andrade²,

Ross³

et al. 1983

Heart

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SUMMARY The long-term follow-up of six patients operated on for aorto-left ventricular communication has been reviewed in detail. All had residual aortic regurgitation after the initial repair of the defect. It was severe in four and required repeated reoperation in three with ultimate aortic valve replacement.The failure of early repair to solve the haemodynamic problem has provoked a reconsideration of the basic anatomy, of the surgical approach, and of the postoperative physiology of this anomaly.The so called "tunnel" is not a tunnel with length but should be considered as a localised breach at the insertion of the right coronary cusp. The localised aortic root dilatation at the site is a weakness that remains after closure of the tunnel leaving a poorly supported aortic valve and a weak root. Thus, the initial repair of the aorto-left ventricular communication must not only close the communication but reinforce, strengthen, and support the right aortic sinus in order to maintain cusp competence.A congenital aorto-left ventricular communication, known as a "tunnel"'I presents as severe aortic regurgitation in the neonate, infant, and child.2 Theoretically, closure of the communication should solve the haemodynamic problem, but reports show that severe aortic regurgitation may persist.3-6 Unfortunately, later aortic valve repair has failed in our hands so that ultimately aortic valve replacement has been necessary in some cases.It was hoped that early closure of the defect would prevent secondary effects on the aortic root and cusps,4 6-8 but our recent experience suggests that this is not so.This has prompted us to review the late results of previously reported patients, add new experience, and reconsider the anatomy of this congenital defect.

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“…This includes four Teflon cusp fatalities, who are included since the necessity for cusp replacement was an expression of a failed debridement. Hospital mortality rates in other large series vary considerably; with Mulder, Kattus, Fonkalsrud, and Longmire (1963) hospital mortality was 14%, with McGoon, Ellis, andKirklin (1965) 14%, Cronin, Reid, Scott, andDobell (1963) 25%, Scannell, Shaw, Burke, Austen, andSaurbrey (1963) 27%, andBaker andSomerville (1964) 31 %. Considerably better results were achieved by Morrow, Austen, and Braunwald (1963) with an 8% hospital mortality, by Hufnagel andConrad (1962) 6%, andHancock, Hultgren, andShumway (1965) Scannell et al (1963) 9% over two to five years, Hancock et al (1965) 10% over an average of 28 months, andMorrow et al (1963) 8 % andHufnagel andConrad (1962) 12% over one year.…”

Section: Discussionmentioning

confidence: 95%