Summary
Since 1974 the new concept of aortoventriculoplasty (AVP) has been applied clinically
in Göttingen. Out of 1,112 patients with various types of congenital aortic stenosis
502 patients have undergone commissurotomy, resection of a subvalvular ring, myotomy
and supravalvular patch plasty. Fifty-seven patients were treated by AVP, in only
11 patients was AVP the first procedure, 46 had had one or more previous operations.
Total hospital mortality was 12.2%; in the last 37 cases there was only one death.
Two patients suffered permanent AV block. The mean left ventricular-aorta gradient
was reduced from 94 ± 24 mmHg to 14 ± 15 mmHg after AVP. In our clinical material
the indications for AVP (n = 57) have been the following: valvular aortic stenosis
with narrow annulus (8 patients), diffuse subaortic stenosis (20) (from collar-like
to tunnel-like, out of these patients 6 with Shone-complex), multi-level stenosis
(20), outgrown prosthesis (4), hypertrophic obstructive cardiomyopathy (5). In comparison
to the apico-aortic conduit procedure and total replacement of the aortic root by
homograft, the clinical results indicate AVP to be a simple and easy-to-apply operative
technique.
Key Words
Aortoventriculoplasty (AVP) - Left ventricular outflow tract - Aortic stenosis
