Possati F, Calafiore A M, Sasso D, Santarelli P, Liore L, Morino F
G Ital Cardiol. 1977;7(10):978-88.
The AA. examine their experience concerning 23 patients operated on for a discrete subaortic stenosis since 1969. Immediate results are satisfactory, even if there have been postoperative complications in 26% of the patients. Late results are less satisfactory, above all because of the progression of aortic insufficiency far from the operation. Date of literature are nor allowing valuable indications about the natural history of the patient after surgical treatment, because of the scarcity of postoperative hemodynamic controls and, especially, of serial examinations. The AA. believe, on the ground of considered data and personal experience, that it is prudent, awaiting for further critical evaluation of late results, to limit surgical indications, in asymptomatic patients, to cases with left ventricular-aortic gradient superior to 70 mmHg.
作者们回顾了自1969年以来23例因单纯主动脉瓣下狭窄接受手术患者的治疗经验。尽管26%的患者术后出现并发症，但近期效果令人满意。远期效果则不太理想，主要是因为远离手术时主动脉瓣关闭不全仍在进展。由于术后血流动力学监测，尤其是系列检查的缺乏，文献数据无法提供关于手术治疗后患者自然病程的有价值指征。作者们基于现有数据和个人经验认为，在等待对远期效果进行进一步严格评估之前，对于无症状患者，谨慎的做法是将手术指征限制在左心室-主动脉压差超过70 mmHg的病例。
