HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Brown, J. Articles by King, H. Search for Related Content PubMed PubMed Citation Articles by Brown, J. Articles by King, H.

Ann Thorac Surg 1985;40:151-155
© 1985 The Society of Thoracic Surgeons

---

Articles

Surgery for Discrete Subvalvular Aortic Stenosis: Actuarial Survival, Hemodynamic Results, and Acquired Aortic Regurgitation

From the Department of Surgery, Section of Cardiothoracic Surgery, and the Department of Medicine Section of Pediatric Cardiology, Indiana University Medical Center, Indianapolis, IN.

Accepted for publication December 28, 1984.

^* Address reprint requests to Dr. Brown, Surgery Department, Emerson Hall 212, Indiana University Medical Center, 545 Barnhill Dr, Indianapolis, IN 46223

Discrete membranous subaortic stenosis (DMSS) accounts for 8 to 30% of congenital left ventricular outflow obstruction. The immediate effectiveness of surgical resection of this discrete obstructing membrane has been well documented, but little has appeared regarding late clinical and hemodynamic follow-up. Fifty-three patients with DMSS underwent operation at our institution from 1957 to 1983. Most (78%) were symptomatic, 79% had left ventricular hypertrophy (LVH) by electrocardiogram, and 92% had roentgenographic evidence of cardiomegaly preoperatively. Catheterization revealed a mean preoperative left ventricular-aortic gradient of 89 mm Hg. Twenty-eight patients had associated aortic insufficiency (AI) on the initial aortogram. Seven patients acquired AI in the interim between the first and second preoperative catheterization.

Our patients have been followed for up to 12 years postoperatively. There have been 2 early and 3 late deaths. (Actuarial analysis revealed 5- and 10-year survival of 95% and 83%, respectively.) Seventy-one percent of the previously symptomatic patients noted relief of their preoperative complaints, and 45% of those with LVH had a regression in voltage. Cardiomegaly as determined by chest roentgenogram decreased in 45%. The left ventricular-aortic gradient fell to an average of 35 mm Hg a year postoperatively.

Surgical treatment of congenital subvalvular aortic stenosis is effective in reducing the preoperative symptoms and the left ventricular-aortic gradient. It appears that DMSS causes AI.

This article has been cited by other articles:

				J. S. de Lezo, M. Romero, J. Segura, M. Pan, J. S. de Lezo, D. Pavlovic, F. Mazuelos, M. Delgado, and D. Mesa Long-Term Outcome of Patients With Isolated Thin Discrete Subaortic Stenosis Treated by Balloon Dilation: A 25-Year Study Circulation, September 27, 2011; 124(13): 1461 - 1468. [Abstract] [Full Text] [PDF]

				M. Ruzmetov, P. Vijay, M. D. Rodefeld, M. W. Turrentine, and J. W. Brown Long-term results of surgical repair in patients with congenital subaortic stenosis Interact CardioVasc Thorac Surg, June 1, 2006; 5(3): 227 - 233. [Abstract] [Full Text] [PDF]

				J. M. Oliver, A. Gonzalez, P. Gallego, A. Sanchez-Recalde, F. Benito, and J. M. Mesa Discrete subaortic stenosis in adults: increased prevalence and slow rate of progression of the obstruction and aortic regurgitation J. Am. Coll. Cardiol., September 1, 2001; 38(3): 835 - 842. [Abstract] [Full Text] [PDF]

				W. M. Gersony Natural history of discrete subvalvar aortic stenosis: management implications J. Am. Coll. Cardiol., September 1, 2001; 38(3): 843 - 845. [Full Text] [PDF]

				M. Jahangiri, I. A. Nicholson, P. J. del Nido, J. E. Mayer, and R. A. Jonas Surgical management of complex and tunnel-like subaortic stenosis Eur J Cardiothorac Surg, June 1, 2000; 17(6): 637 - 642. [Abstract] [Full Text] [PDF]

				S. T. Rayburn, D. E. Netherland, and B. J. Heath Discrete Membranous Subaortic Stenosis: Improved Results After Resection and Myectomy Ann. Thorac. Surg., July 1, 1997; 64(1): 105 - 109. [Abstract] [Full Text]

				R. C. Elkins Congenital aortic valve disease: Evolving management Ann. Thorac. Surg., February 1, 1995; 59(2): 269 - 274. [PDF]

				F. M. Lupinetti, A. K. Pridjian, L. B. Callow, D. C. Crowley, R. H. Beekman, and E. L. Bove Optimum treatment of discrete subaortic stenosis Ann. Thorac. Surg., September 1, 1992; 54(3): 467 - 471. [Abstract] [PDF]

				P. R. Vouhe and J.-Y. Neveux Surgical management of diffuse subaortic stenosis: An integrated approach Ann. Thorac. Surg., September 1, 1991; 52(3): 654 - 661. [Abstract] [PDF]

				E. C. Douville, R. M. Sade, F. A. Crawford Jr, and H. B. Wiles Subvalvar aortic stenosis: Timing of operation Ann. Thorac. Surg., July 1, 1990; 50(1): 29 - 33. [Abstract] [PDF]

				J. W. Brown, L. S. Stevens, S. Holly, R. Robison, M. Rodefeld, T. Grayson, B. Marts, R. A. Caldwell, R. A. Hurwitz, D. A. Girod, et al. Surgical spectrum of aortic stenosis in children: A thirty-year experience with 257 children Ann. Thorac. Surg., April 1, 1988; 45(4): 393 - 403. [Abstract] [PDF]