OBJECTIVE: To discuss the use of new technology in the chemical demineralization of the aortic valve in coronary artery bypass surgery, together with its hemodynamic changes and to report events related to the technique. METHOD: Five patients with mild to moderate aortic stenosis submitted to myocardial revascularization underwent chemical treatment of the aortic valve. The patients' ages ranged from 65 to 81 years, with a mean of 73 years. All were men. One patient had the involvement of a single artery and four multiple arteries (four vessels). The gradient ranged from 13 to 49 mmHg, with a mean of 25 mmHg. The size of the aortic orifice ranged from 0.8 to 1.3 cm², with a mean of 1.1 cm². The following antecedents were observed: arterial hypertension, hypercholesterolemia, diabetes mellitus and smoking. RESULTS: The aorta clamping time ranged from 94 to 126 minutes, with a mean of 107 minutes and the bypass time was from 134 to 171 minutes, with a mean of 152 minutes. The time of surgery was from 13 to 33 minutes with a mean of 28 minutes. No deaths were recorded. The only postoperative complication noted was a total AV block in three patients. No events were observed that might impair the integrity of the aortic valve or cause aortic insufficiency following treatment. Likewise, no neurologic, systemic, metabolic or hematologic events were seen. The postoperative transvalvular gradient identified by echocardiography showed an improvement in the systolic gradient and in the mean gradient. CONCLUSIONS: The treatment proved to be effective and safe, causing no lesions of the valve or any systemic event. The changes in the conduction system appear to be related to the equipment and its system of releasing the lavage solution. The use of this technology may, in the future, be an important adjuvant in aorta valve replacement using percutaneous techniques.
Aortic valve; surgery; Aortic valve stenosis; Decalcification technique; Calcinosis; Demineralization
