Does aortic commissurotomy improve clinical outcomes and pressure gradients in patients with rheumatic aortic stenosis?
Aortic commissurotomy provides significant clinical improvement and reduces pressure gradients in patients with rheumatic aortic stenosis.
THE surgical treatment of rheumatic aortic stenosis depends upon the ability to split commissural fusion by digital or instrumental means. The initial technic1 required an entrance into the left ventricle through its muscular wall, but more recently the aorta itself has served as the portal to the valve.2 The results of the operation reveal significant clinical improvement in many patients with major manifestations of the lesion.3 , 4 Furthermore, physiologic data in a small series of patients have shown that striking modifications in pressure gradients across the orifice of the valve are attainable.5 These encouraging results are tempered by specific cases in . . .
Litwak et al. (Thu,) studied this question.