Aortic Incompetence: The Eventual Outcome in a Small Series Treated with Hufnagel's Descending Aorta Ball-Valve

Before the open-heart surgery era, 5 patients with severe AI had a Hufnagel ball-valve inserted into their descending aorta. Four survived operation, but there were two early deaths. The remaining two initially improved, but later their cardiac condition deteriorated. One was, furthermore, badly incapacitated by the noise from his valve. Re-operations were performed about a decade later. One died after the removal of his aortic valve and insertion of a Starr-valve. The cause of death was uraemia initiated by thrombosis of the aorta distal to the Hufnagel-valve, i.e. at the level of the renal arteries. The last patient had his aortic valve replaced by a Starr-valve and, 10 weeks later, his Hufnagel-valve removed. The continuity of the descending aorta was re-established by means of a Teflon-graft. He is fit and well and—kto our knowledge—the only published case still living after radical correction of AI following a previous Hufnagel procedure.