RT Book, Section A1 Emery, Robert W. A1 Emery, Ann M. A1 Hommerding, Jan A1 Raikar, Goya V. A2 Cohn, Lawrence H. SR Print(0) ID 55920018 T1 Chapter 32. Aortic Valve Replacement with a Mechanical Cardiac Valve Prosthesis T2 Cardiac Surgery in the Adult, 4e YR 2012 FD 2012 PB The McGraw-Hill Companies PP New York, NY SN 978-0-07-163310-9 LK accesssurgery.mhmedical.com/content.aspx?aid=55920018 RD 2024/03/29 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 (Fig. 32-1).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 50 years3 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), percutaneous or transapical biologic valves and a combination of a biologic valve using a pulmonary autograft, and pulmonary outflow tract replacement with heterograft prostheses (Ross procedure). This chapter focuses on the use of mechanical valve replacement in the aortic position.