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Ann Thorac Surg 1996;61:1297-1298
© 1996 The Society of Thoracic Surgeons

Editorials

The Aortic Valve: To Dilate, Repair, or Replace—That Is the Question

John J. Lamberti, MD

Division of Cardiac and Thoracic Surgery, Department of Surgery, Children's Hospital and Health Center of San Diego, Children's Heart Institute of San Diego, San Diego, California

The first 20% of the full text of this article appears below.

In this issue of The Annals of Thoracic Surgery, Hawkins and associates [1] seek to examine the ``incidence, indications, and results of surgical repair or replacement of the aortic valve after balloon aortic valvuloplasty (BAV) for congenital aortic stenosis in children.'' In the process, Hawkins and associates present good evidence that aortic valve repair is still possible after disruption of the aortic valve by balloon dilation. Twenty-three of 60 patients undergoing BAV required operation at 44 ± 37 months after BAV. Creative techniques including leaflet repair, leaflet shaving, and commissurotomy were used to salvage nine valves. Fourteen patients underwent various types of valve replacement.

Historically, the early and late mortality and morbidity after aortic valve replacement in infants and children were substantial. In recent years, enthusiasm for the Ross procedure (pulmonary autograft) has created the conceptthat a ``curative'' operation could be performed for aortic valve disease in infants and children [2, 3]. However, not all pulmonary autograft valves are competent, and some have required re-replacement. The homograft in the pulmonary position will not grow and on some occasions may become inexplicably stenotic. It is also likely . . . [Full Text of this Article]


Related Article

Aortic Valve Repair and Replacement After Balloon Aortic Valvuloplasty in Children
John A. Hawkins, L. Luann Minich, Robert E. Shaddy, Lloyd Y. Tani, Garth S. Orsmond, Jane E. Sturtevant, and Edwin C. McGough
Ann. Thorac. Surg. 1996 61: 1355-1358. [Abstract] [Full Text]



This article has been cited by other articles:


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 Ann. Thorac. Surg.Home page
V. L. Vida, T. Bottio, O. Milanesi, E. Reffo, R. Biffanti, R. Bonato, and G. Stellin
Critical Aortic Stenosis in Early Infancy: Surgical Treatment for Residual Lesions After Balloon Dilation
Ann. Thorac. Surg., January 1, 2005; 79(1): 47 - 51.
[Abstract] [Full Text] [PDF]


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