Débridement-valvotomy for aortic stenosis in adults

摘要

Seventy-six adults who had débridement-valvotomy for severe aortic stenosis are reviewed. Of these, 61 had isolated aortic valve stenosis and 15 had multivalvar disease. Twenty-six patients (34%) died at or subsequent to surgery. Thirty-eight of the 40 survivors with isolated aortic valve disease have been followed up for between 21 and 70 (mean 46) months after surgery, and detailed evidence as to the state of the aortic valve was obtained in 34 of these either by left heart catheterization or at operation. Only one result was completely acceptable. The great majority of patients were found to have redeveloped important aortic stenosis, and in many this was already sufficiently severe to warrant further surgery. The initial degree of valve calcification seemed to have little bearing on the final result except in the multivalve group. Other series are reviewed. The operation has become increasingly unpopular, but reports continue to suggest that it may still have a place. Our results suggest that the procedure should be discarded.