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

This Article Alert me when this article is cited Alert me if a correction is posted 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 Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by King, R. M. Articles by Piehler, J. M. Search for Related Content PubMed PubMed Citation Articles by King, R. M. Articles by Piehler, J. M.

The Annals of Thoracic Surgery, Vol 42, 269-272, Copyright © 1986 by The Society of Thoracic Surgeons

ARTICLES

Mechanical decalcification of the aortic valve

RM King, JR Pluth, ER Giuliani and JM Piehler

Thromboembolism and anticoagulant-related complications secondary to prosthetic aortic valve replacement constitute a significant risk (28% at 5 years). From 1978 through 1984, decalcification of the aortic valve was performed in 8 patients who were undergoing coronary artery revascularization. Preoperative gradients of between 30 and 80 mm Hg (mean, 50 mm Hg) were abolished after operation. To determine the viability of decalcification, the records of 84 additional patients who had undergone this procedure between 1959 and 1978 were reviewed (86% before 1965). There were 60 male and 32 female patients ranging from 14 to 74 years old (mean, 49 years). The cause of the calcification was a bicuspid valve in 32 patients (35%), senile calcification in 9 (10%), and rheumatic fever in 50 (54%); the cause in 1 patient was unknown. Thirty-day mortality was 13%. Follow-up was 98% complete and ranged from 6 months to 22 years (mean, 7 years). Aortic valve replacement was subsequently required in 25 patients. Freedom from reoperation at 1, 5, 10, and 15 years was 98%, 75%, 43%, and 26%, respectively, for patients with rheumatic valves compared with 97%, 76%, 57%, and 51%, respectively, for those with bicuspid valves. Survival for patients with rheumatic valves at 1, 5, 10, 15, and 20 years was 93%, 70%, 48%, 40%, and 35%, respectively, compared with 100%, 66%, 57%, 46%, and 46% for patients with bicuspid valves. At follow-up, 61% of the patients were in New York Heart Association Functional Class I or II. Causes of late death were valve related (30%), congestive heart failure (27%), and myocardial infarction (24%).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				J. A. Carr and E. B. Savage Aortic valve repair for aortic insufficiency in adults: a contemporary review and comparison with replacement techniques Eur. J. Cardiothorac. Surg., January 1, 2004; 25(1): 6 - 15. [Abstract] [Full Text] [PDF]

				D. L.-M. Wiegand Advances in Cardiac Surgery: Valve Repair Crit. Care Nurse, April 1, 2003; 23(2): 72 - 90. [Full Text] [PDF]

				N. Kitamura, S. Uemura, R. Kunitomo, J. Utoh, and S. Noji A new technique for debridement in rheumatic valvular disease: the rasping procedure Ann. Thorac. Surg., January 1, 2000; 69(1): 121 - 125. [Abstract] [Full Text] [PDF]