CURRENT ETIOLOGIES OF CHRONIC OR SUBACUTE SURGICAL PURE AORTIC-INSUFFICIENCY IN ADULTS - BASED UPON 91 MEDICOSURGICAL CASES

Current etiologies of chronic or subacute surgical pure aortic insuffi ciency in adults: based upon 91 medico-surgical cases. - Ninety one pa tients (78 men, mean age 53; 13 women, mean age 50) from a geographica lly stable and ethnically homogeneous population (Eastern Brittany) un derwent surgery for chronic or subacute aortic insufficiency (Al), pre sent alone, between 1986 and 1992 (72 aortic valve replacements, 17 Be ntall type (Cabrol modification) operations, 2 ascending aorta reducti on plasties combined with aortic valve replacement). Preoperative clin ical and paraclinical findings were reviewed in the context of peroper ative and pathological findings. Etiologies were as follows in decreas ing order of frequency: 1) degenerative: 40 cases (44 %) : 34 men and 6 women, with aneurysm of the ascending aorta (19 cases); 2) sequelae of infectious endocarditis : 20 cases (22 %): 14 men, 6 women; 3) post -inflammatory (rheumatic): 16 cases (18 %) : 16 men; 4) congenital bic uspid valves: 15 cases (16 %): 14 men, 1 woman. Chronic (or subacute) surgical Al is currently an essentially male disorder, presenting main ly during the 6th decade of life, the foremost cause of which, identif iable in the majority of cases on the basis of simple preoperative fin dings, is degenerative disease of the aorta of or the aortic valve its elf.