Surgical treatment of aortic valve disease in the nineties with special emphasis on the use of the pulmonary autograft (Ross-operation).
Aortic valve surgery is no longer only a question of immediate survival but as much a question of long term outcome and quality of life. The need for lifelong anticoagulation limits quality of life and carries a significant risk of complications. The new options available to avoid anticoagulation are technically more demanding and our knowledge about the long-term results after these operations is limited. If the patient is willing to accept the prospect of a reoperation to avoid a valve prosthesis he is doing this to get a better quality of life and a lower risk of valve or anticoagulation related complications. We believe that this is a reasonable choice because of the generally improved safety of heart surgery and because we have an increased experience of advanced surgery and reoperations. For patients with advanced endocarditis we are convinced of the superiority of homografts and autografts. In children autograft growth capability and expected superior durability are very important arguments. The final strategy for optimal management of aortic valve disease is yet to be developed. We do not believe in one simple solution for all patients. If the Ross-operation is a step forward, it is in the direction of increased complexity to improve quality of life for the patients.
Pettersson
G
G
Department of Cardiothoracic Surgery, National University Hospital, Copenhagen, Denmark.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001021:Aortic Valve / Q000473:pathology / Q000601:surgery*; D001705:Bioprosthesis; D002648:Child; D002675:Child, Preschool; D005260:Female; D006349:Heart Valve Diseases / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011664:Pulmonary Valve / Q000637:transplantation*; D014182:Transplantation, Autologous