RT Book, Section
A1 Emery, Robert W.
A1 Voeller, Rochus K.
A1 Emery, Robert J.
A2 Cohn, Lawrence H.
A2 Adams, David H.
SR Print(0)
ID 1144153052
T1 Aortic Valve Replacement with a Mechanical Cardiac Valve Prosthesis
T2 Cardiac Surgery in the Adult, 5e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071844871
LK accesssurgery.mhmedical.com/content.aspx?aid=1144153052
RD 2024/04/19
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.