HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Constantine Mavroudis Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mavroudis, C. Articles by Elbl, F. Search for Related Content PubMed PubMed Citation Articles by Mavroudis, C. Articles by Elbl, F.

Ann Thorac Surg 1984;38:237-241
© 1984 The Society of Thoracic Surgeons

---

Articles

The Prognostic Value of Intraoperative Pressure Gradients with Congenital Aortic Stenosis

Departments of Surgery and Pediatrics, University of Louisville School of Medicine, Louisville, KY

^* Address reprint requests to Dr. Mavroudis, Department of Surgery, Ambulatory Care Building, University of Louisville School of Medicine, Louisville, KY 40292

Patients with congenital aortic stenosis are subject to sudden death without prior symptoms. Indications for operation are based on pressure gradients, but intraoperative evaluation of results after relief of obstruction can be subjective and arbitrary. Between September, 1981, and October, 1983, 21 patients underwent operation for relief of congenital aortic stenosis. Fifteen had valvular, 4 had supravalvular, and 2 had subvalvular stenosis. Seven patients were 1 year of age or younger, 2 being 3 days old. Preoperative inotropic support and emergency operation were necessary in 2 patients. Intraoperative pressure gradients were measured in all but the 2 patients who were 3 days old. All patients survived without complications. Intraoperative and postoperative pressure gradients were available in 16 patients. The average preoperative pressure gradient was 76 mm Hg. It was significantly lowered to 20 mm Hg (p < 0.001) intraoperatively, which compared with 15 mm Hg postoperatively. Three patients had an unsatisfactorily high intraoperative pressure gradient after initial intervention. Immediate reexploration and incision of the rudimentary commissure in 2 and excision of redundant valvular tissue in the other resulted in a more satisfactory pressure gradient without substantial aortic insufficiency. We suggest that measurement of intraoperative pressure gradients can accurately assess the results of therapy and allow the surgeon the option of reexploration for further intervention. Moreover, the high correlation between intraoperative and postoperative pressure gradients can help in planning postoperative management and future cardiac catheterizations.

This article has been cited by other articles:

				C. Mavroudis and R. M. Sade The Southern Thoracic Surgical Association 50th anniversary celebration: the impact of STSA pediatric cardiothoracic surgery manuscripts on surgical practice Ann. Thorac. Surg., November 1, 2003; 76(90050): S47 - 67. [Abstract] [Full Text] [PDF]