Commissurotomy for Rheumatic Aortic Stenosis

Abstract

As long ago as the middle of 1949 it had been demonstrated by the senior author that any blunt dilating mechanism applied within the stenotic aortic orifice would, upon expansion, force the separation of one or more of the fused commissures. Thus the diminutive valve orifice could be enlarged without the creation of additional insufficiency and with the restoration of such part of the original valve function as the pathologic distortion of the leaflets would permit. In other words the principles and effectiveness of such an aortic commissurotomy would be comparable to those of the similarly named operation for mitral stenosis. It has remained for us finally to develop an instrument and a technic capable of implementing these concepts, and this has at last been accomplished.

Aortic Valvular Stenosis With Coarctation of the Aorta: With Special Reference to the Development of Aortic Stenosis Upon Congenital Bicuspid Valves

“…Kiloh (1950) concluded that a congenital bicuspid valve may well play an important role in the development of calcific aortic stenosis. A similar conclusion is reached by Bailey et al (1954).…”

Über die Häufigkeit der Koronarsklerose bei Aortenstenose

“…Die große Operations-Mor talität stellt die größte Schwierigkeit dar. Sie beträgt ungefähr 20%; sie ist etwas niedriger hei der transaortalen und etwas höher hei der transventrikulären Methode (1)(2)(3)(4)(5)(6)(7)(8)(9)(10).…”

“…3 6 Schweizer, ü b e r die Häufigkeit Dieses Ergebnis bestätigt dasjenige einer Anzahl früherer Unter suchungen (19,24,27). Es steht jedoch im Widerspruch zu ande ren (7,20,22,23,28 (1,3,7,9,18,27), kann viel leicht auch durch den Altersunterschied der Operierten erklärt werden. Bei begleitender Mitralstenose wird der Kranke den Arzt früher aufsuchen und damit vielleicht früher zur Operation ge langen.…”

Reconstructive surgery for aortic valve disease

“…This accomplishment inspired the development of different techniques of aortic valvotomy in the fifties [7][8][9][10] , with varying degrees of both success and complication, including valvar insufficiency.…”