| Aortoventriculoplasty for tunnel subaortic stenosis and other obstructions of the left ventricular outflow tract. Clinical and hemodynamic results. | |
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MedLine Citation:
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PMID: 571774 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A new therapeutic concept of enlarging the outflow tracts of both ventricles with a patch and inserting an aortic prosthesis has been developed for the treatment of tunnel subaortic stenosis. This operation has been applied clinically since June 1974 on several types of obstruction in the outflow tract of the left ventricle. Twenty-one operations have been performed on 20 patients under the age of 18 years, with an overall mortality of 24% and no late deaths. Seven patients developed complete right bundle branch block or left anterior hemiblock or both as a result of this operation; transient atrioventricular block and complete left bundle branch block occurred in one patient each. In no case, however, did rhythm disturbances contribute to death. In one patient, the septal incision injured a septal coronary artery, with fatal result. Fourteen patients had catheterization studies postoperatively. Although previous conventional surgery had been unsuccessful, aortoventriculoplasty (AoVPI) reduced the mean gradient across the left ventricular outflow tract significantly (p less than or equal to 0.01), from 94.7 +/- 25.5 mm Hg to 14.4 +/- 17.2 mm Hg, leaving the end-diastolic pressure practically unchanged. No significant defect remained in the patch-covered septal incision. Thus, we consider AoVPI to be the operation of choice for tunnel subaortic stenosis, for valvular aortic stenosis with a narrow annulus and in cases where an artificial aortic valve has become too small because of the patient's growth. |
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Authors:
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P G Björnstad; H Rastan; J Keutel; A J Beuren; J Koncz |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Circulation Volume: 60 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1979 Jul |
Date Detail:
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Created Date: 1979-08-16 Completed Date: 1979-08-16 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 59-69 Citation Subset: AIM; IM |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Angiocardiography Aorta / surgery* Aortic Stenosis, Subvalvular / congenital*, physiopathology, surgery Aortic Valve / abnormalities*, physiopathology, surgery Blood Vessel Prosthesis* Cardiomyopathy, Hypertrophic / congenital* Child Child, Preschool Echocardiography Female Follow-Up Studies Heart Catheterization Heart Conduction System / physiopathology Heart Valve Prosthesis* Heart Ventricles / surgery* Humans Male Phonocardiography Postoperative Complications / mortality Pulse |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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