Aortic valve surgery as an emergency procedure.

Twenty-three patients critically ill from aortic valvular disease underwent emergency aortic valve replacement as a life-saving measure. Sixteen patients (70%) survived hospitalization and 14 (61%) are presently living. Of eighteen patients who underwent solitary aortic valve replacement, there were four hospital deaths and two late deaths. Five patients required double valve surgery, with three hospital deaths and no late deaths. The survivors often had dramatic improvement and have done well during an average follow-up period of 9 months. The major factor contributing to mortality after surgery was irreversible myocardial damage particularly evident in patients with longstanding severe valvular disease. Valve replacement can be successfully accomplished in patients critically ill with aortic valve disease, especially if it occurs as an isolated lesion.