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(Circulation. 1960;21:578.)
© 1960 American Heart Association, Inc.

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Open Operation in the Treatment of Calcific Aortic Stenosis

JOHN W. KIRKLIN M.D.¹ HAROLD T. MANKIN M.D.¹

¹ From the Mayo Clinic and the Mayo Foundation, Rochester, Minn. The Mayo Foundation is a part of the Graduate School of the University of Minnesota.

Calcareous disease of the aortic valve, diagnosed by fairly uniform signs and measurements, has been treated in 14 cases at the Mayo Clinic by an open surgical technic with utilization of extracorporeal circulation. One patient died during the operation and another died after leaving the hospital. Among 7 cases followed 6 to 9 months after operation, definite symptomatic improvement has been shown in 6.

This disease is very dangerous, but a small improvement in the size of the valvular orifice can bring important benefits. The open operation is advantageous in avoidance of creating or aggravating insufficiency while relieving stenosis.

Presently this operation is advised for patients whose disability is significant or progressing. Severe coexisting coronary artery disease is a contraindication; but associated aortic valvular insufficiency, advanced degrees of disability, and left ventricular failure are not.