Aortic Stenosis

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Abstract
A 5-year evaluation of aortic stenosis for cardiac surgery was reviewed with emphasis on preoperative diagnosis and surgical treatment. The decisive point in preoperative diagnosis was the measurement of systolic aortic valve gradient by left ventricular puncture, which was carried out in all 114 patients. The history and other findings were correlated with the gradient. Increasing dyspnea, chest pains and syncope were the most important points in the history. The physical findings were dominated by a systolic murmur and a weak 2nd aortic sound. There was good correlation between the phonocardiographic registration of a late maximum of the systolic murmur and the systolic gradient. The correlation between voltage in precordial leads as an indication of left ventricular hypertrophy and the gradient was weaker. Sixty-three of the patients were operated on. The most common operation was debridement. In a few cases insertion of Teflon-transplant to the valves was carried out. The operative mortality was 13%. During the follow-up a further 3 patients died. Considerable improvement was noted in 1/2 of the patients while the other 1/2 were unchanged or worse. In patients with heavily calcified aortic valves artificial valves should be implanted.