Article

lock Open Access lock Peer-Reviewed

615

Views

CASE REPORT

Apico-aortic valved conduct for surgical treatment of aortic valve and ascending aorta calcification

Luís Alberto DallanI; Sérgio Almeida de OliveiraI; Paulo M Pêgo-FernandesI; José Carlos R IgléziasI; Geraldo VerginelliI; Adib D JateneI

DOI: 10.1590/S0102-76381993000100005

ABSTRACT

A method of surgical correction for patients with acquired aortic stenosis involving calcification of the aortic valve and the ascending aorta has been described. A prosthesis to a 21 mm biological valved conduit, interposed between the left ventricular apex and descending thoracic aorta, permits the left ventricle to bypass the obstruction and eject directly into the aorta. The pressure gradient across the aortic valve was decreased from 75 to 31 mmHg, with a 13 mmHg gradient between the left ventricle and the valved conduit. The patients remains assymptomatic four mounths after the operation, without fatigue or shortness of breath.

RESUMO

É descrito método para correção cirúrgica da estenose aórtica adquirida, conseqüente a calcificação da valva aórtica e da aorta ascendente. Foi empregado tubo de Dacron preparado especialmente para o caso, valvulado com prótese biológica número 21, interposto entre o ápice do ventrículo esquerdo e a aorta torácica descendente. Esse conduto permitiu ao fluxo sangüíneo proveniente do ventrículo esquerdo (VE) ultrapassar a obstrução de sua via de saída, sendo ajetado diretamente na aorta descendente. O gradiente pressórico através da valva aórtica reduziu-se de 75 mmHg para 35 mm Hg e o gradiente registrado entre o VE e o conduto valvulado foi de 13 mmHg. A paciente teve boa evolução hospitalar, permanecendo assintomática decorridos quatro meses da operação.
Full text available only in portuguese PDF format.

REFERENCES

1. ANDERSON, R. H.; BECKER, A. E.; WILCOX, B. R. - Aortic valve stenosis: ethnology and pathology. In: HURST, J. W. Diseases of the heart. New York, Mc Graw-Hill Book Company. 1988. Parte II, p. 4.2-4.12.

2. BAILEY, C. P.; GLOVER, R. P.; O NEIL, T. J. E.; REDONDO-RAMIREZ, H. P. - Experience with the experimental surgical relief of aortic stenosis: a preliminary report. J. Thorac. Surg., 20: 516-541, 1950. [MedLine]

3. BAILEY, C. P.; REDONDO-RAMIREZ, H. P.; LARZELENE, H. B. - Surgical treatament of aortic stenosis. JAMA, 150: 1647-1652, 1952.

4. BERNHARD, W. F.; POIRIER, V.; LA FARGE, C. G. - Relief of congenital obstruction to left ventricular outflow with a ventricular-aortic prosthesis. J. Thorac. Cardiovasc. Surg., 69: 223-229, 1975. [MedLine]

5. COOLEY, D. A. - Aortic valve procedures. In: Cooley, D. A. Techniques in cardiac surgery. New York, W. B. Sauders Company, 1984. Vol. 15, p. 177-200.

6. COOLEY, D. A.; NORMAN, J. C; REUL Jr., G.; KIDD, J. N.; NIHILL, M. R. - Surgical treatment of left ventricular outflow obstruction with apico-aortic valved conduit. Surgery, 80: 674-680, 1976. [MedLine]

7. HUFNAGEL, C. A. & HARVEY, W. P. - The surgical correction of aortic regurgitation: preliminary report. Bull. Georgetown University Med. Center, 6: 60, 1952.

8. KIRKLIN, J. W. & BARRAT-BOYES, B. G. - Acquired valvular heart disease. In: KIRKLIN, J. W. & BARRAT-BOYES, B. G. - Cardiac surgery. London, Churchill Livingstone, 1993. Cap. 12, p. 492-523.

9. NORMAN, J. C.; NIHILL, M. R.; COOLEY, D. A. - Valved apico-aortic composite conduits for left ventricular outflow tract obstructions. Am. J. Cardiol., 45: 1265-1271, 1980. [MedLine]

10. SARNOFF, S. J.; DONOVAN, T. J.; CASE, R. B. - The surgical relief of aortic stenoses by means of apical-aortic valvular anastomoses. Circulation, 2: 564, 1955.

11. SMITH, H. G. & PARKER, E. F. - Experimental aortic valvulotomy: preliminary report. Surg. Gynecol. Obstet., 34: 625, 1947.

12. STARR, A.; EDWARDS, M. L.; Mc CORD, C. W.; GRISWOLD, H. E. - Aortic replacement: clinical experience with a semirigid ball-valve prosthesis. Circulation, 27: 779-783, 1963.

Article receive on Sunday, March 28, 1993

CCBY All scientific articles published at www.bjcvs.org are licensed under a Creative Commons license

Indexes

All rights reserved 2017 / © 2024 Brazilian Society of Cardiovascular Surgery DEVELOPMENT BY