The Annals of Thoracic Surgery, Vol 57, 1351-1353, Copyright © 1994 by The Society of Thoracic Surgeons
Direct-vision aortic valvotomy: predecessor to modern aortic surgery
RM Ungerleider
Department of Surgery, Duke University Medical Center, Durham, NC 27710.
In 1956, Swan and Kortz described a direct-vision aortic valvotomy
performed through a transaortic approach during caval occlusion and
moderate hypothermia. The rationale for this approach was based on careful
thought and review of relevant information that was available at that time.
Although cardiopulmonary bypass has since supplanted inflow occlusion to
enable exposure of the aortic valve during operation, the principles
considered by Swan and Kortz have survived decades of change. Their
contribution heralded the beginning of modern aortic surgery while
demonstrating the carefulness of thought supported by the audaciousness of
conviction that characterizes innovation in surgery.