Aortic Debridement-Long-term Follow-up

Abstract

The clinical and hemodynamic data available in the five-to eight-year follow-up of 45 patients who underwent aortic debridement for aortic stenosis are presented. Eight patients (18%) remain in follow-up (average duration 6.4 years) with excellent clinical results. Twenty-seven (60%) of these patients have undergone a second operative procedure for correction of aortic stenosis, having achieved an average of 4.3 years of palliation prior to the second operative procedure. Including the operative deaths occurring with the second procedure and the subsequent follow-up of these patients, 29 patients are alive with average follow-up period of 5.7 years. Two of these deaths were not due to cardiovascular disease. Substantial residual aortic gradients were compatible with excellent periods of palliation, provided a reduction of the gradient for the particular patient was achieved. We feel that operative debridement for aortic stenosis, when technically feasible, is a realistic approach to this disease state. Although reoperation may eventually be necessary in the course of the patient's disease, a significant period of palliation with limited morbidity is gained by the patient.