TY - CHAP M1 - Book, Section TI - Aortic Valve Replacement with a Mechanical Cardiac Valve Prosthesis A1 - Emery, Robert W. A1 - Voeller, Rochus K. A1 - Emery, Robert J. A2 - Cohn, Lawrence H. A2 - Adams, David H. Y1 - 2017 N1 - T2 - Cardiac Surgery in the Adult, 5e AB - In 1931, Paul Dudley White stated “There is no treatment for aortic stenosis.” Even today the medical therapy of aortic stenosis has not significantly advanced.1 Conversely, patients may tolerate aortic insufficiency for many years, but as the ventricle starts to dilate, a progressive downhill course begins and early operation is warranted.2 Definitive therapy for aortic valve disease was unavailable until the advent of cardiopulmonary bypass. Innovative cardiovascular surgeons then began to develop cardiac valve prostheses. Over the subsequent 60 years,3 the variety of prostheses that have become available for use have expanded greatly. Available aortic valve substitutes include mechanical valve prostheses, stented biologic valve prostheses, stentless biologic valve prostheses, human homograft tissue (both as isolated valve replacement and aortic root replacement), and a combination of a biologic valve utilizing a pulmonary autograft and pulmonary outflow tract replacement with heterograft prostheses (Ross procedure). Most recently, innovative transarterial/apical aortic valve replacement (TAVR) has gained approval in Europe and North America with acceptable intermediate term results.4 Reports of the use of novel sutureless bioprosthetic valves are appearing.5 This chapter focuses on the use of mechanical valve replacement in the aortic position. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1144153052 ER -