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Ann Thorac Surg 1990;49:429-434
© 1990 The Society of Thoracic Surgeons

Articles

Transatrial relief of diffuse subaortic stenosis after ventricular septal defect closure

Serafin Y. DeLeon, MD*,a,b,c, Michel N. Ilbawi, MDa,b,c, Rene A. Arcilla, MDa,b,c, Otto G. Thilenius, MD, PhDa,b,c, Jose A. Quinones, MDa,b,c, Elise C. Duffy, MDa,b,c, Rabi F. Sulayman, MDa,b,c

a The Heart Institute for Children, Christ Hospital and Medical Center, Oak Lawn USA
b Divisions of Cardiovascular-Thoracic Surgery and Cardiology, The Children's Memorial Hospital USA
c Departments of Surgery and Pediatrics, Northwestern University Medical School, Chicago, Illinois USA

Accepted for publication November 7, 1989.

* Address reprint requests to Dr DeLeon, The Heart Institute for Children, Christ Hospital and Medical Center, 4440 W 95th St, Oak Lawn, IL 60453.

Transatrial enlargement of the left ventricular outflow tract for serious obstruction was performed in 3 patients with previous ventricular septal defect closure. Two patients had recurrent subaortic stenosis as resection had already been performed at initial operation. In all patients, the obstruction was located below the ventricular septal defect patch. Patch enlargement of the left ventricular outflow tract was carried out by opening the ventricular septal defect patch through the tricuspid valve and extending the incision downward through the area of obstruction and the left ventricular body. All patients had uneventful postoperative course and effective relief of left ventricular outflow tract obstruction. We feel that the approach is simple and effective; it avoids a right ventriculotomy and provides a viable option in certain patients with left ventricular outflow tract obstruction.




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