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Surgical Palliation and Restenosis After Blind Transventricular Aortic Commissurotomy

WILLARD P. JOHNSON, MD; LEONARD A. COBB, MD; ROBERT A. BRUCE, MD; K. ALVIN MERENDINO, MD

Arch Intern Med. 1964;113(5):706-710.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

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 . . . [Full Text PDF of this Article]

Author Affiliations
SEATTLE

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

Footnotes
Received for publication Oct 8, 1963; accepted Nov 21.

Clinical Instructor in Medicine, University of Washington, Chief of Research US Public Health Hospital (Dr. Johnson); Associate Professor of Medicine, University of Washington, Chief of Cardiology, King County Hospital (Dr. Cobb); Professor of Medicine, University of Washington (Dr. Bruce); Professor of Surgery, University of Washington (Dr. Merendino).

This study was supported in part by grants HE-00908 and H03379 from the National Institutes of Health.

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