Early closed surgical techniques for calcific aortic stenosis were limited in efficacy and associated with significant complications.
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Early closed-technique failures informed the shift to open and transcatheter approaches; leaves open optimal selection in current AS subsets.
THE transventricular and transaortic approaches, with visualization of the valve, to correct calcareous aortic stenosis were logical and progressive strides in the development of the surgical management of this disease.1 2 3 4 However, these procedures at best were limited to attempts to increase the size of the orifice by blind instrumental or digital splitting of the commissural zones. In the presence of the usual extensive calcification or fibrosis, or both, incision or avulsion along one or two lines of fusion did not necessarily increase markedly the area for blood flow. These closed technics were also complicated by embolization and aortic insufficiency, since . . .
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Hufnagel et al. (1962) studied this question.
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