A Clinical Survey of 20 Patients Submitted to Aortic Valvuloplasty

Aortic stenosis occurs in approximately 25 per cent of all patients with chronic valvular disease. In patients with aortic stenosis, the appearance of symptoms of angina, syncope, or left ventricular failure indicates an average prognosis of two to three years (Bergeron et al., 1954; Anderson, 1961). This is in striking contrast to mitral stenosis in which disability may be present for many years before death. In view of the short prognosis following the onset of symptoms, it is not surprising that operative correction has been actively sought for symptomatic patients with aortic stenosis. The introduction of closed aortic valvotomy ten years ago, either by the transventricular or trans- aortic approach, was associated not only with a moderately high operative mortality, but also with a high incidence of late deaths attributable to inadequate relief of the stenotic lesion or the production of aortic regurgitation at operation (Abelmann and Ellis, 1959; Kraus et al., 1959). More recently, improvements in surgical technique enable the correction of this lesion to be undertaken under direct vision allowing either more definitive mobilization of the valve cusps, or replacement of part or all of the aortic valve with prosthetic material (Kirklin and Mankin, 1960).