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Clinical Analysis of Surgical Results for Discrete Subaortic Stenosis  

Yu Song Hyeon (Department of Rhoracic & Cardiovascular Surgery, Yonsei Cardiovasculr Center, Yonsei University College of Medicine)
Lim Sang Hyun (Department of Rhoracic & Cardiovascular Surgery, Yonsei Cardiovasculr Center, Yonsei University College of Medicine)
Hong You Sun (Department of Rhoracic & Cardiovascular Surgery, Yonsei Cardiovasculr Center, Yonsei University College of Medicine)
Park Young Hwan (Department of Rhoracic & Cardiovascular Surgery, Yonsei Cardiovasculr Center, Yonsei University College of Medicine)
Chang Byung Chul (Department of Rhoracic & Cardiovascular Surgery, Yonsei Cardiovasculr Center, Yonsei University College of Medicine)
Kang Meyun Shick (Department of Rhoracic & Cardiovascular Surgery, Yonsei Cardiovasculr Center, Yonsei University College of Medicine)
Publication Information
Journal of Chest Surgery / v.38, no.8, 2005 , pp. 545-550 More about this Journal
Abstract
Background: Discrete subaortic stenosis is known to recur frequently even after surgical resection. We retrospectively reviewed the preoperative and postoperative changes in pressure gradient through left ventricular outflow tract, and the recurrence rate. Material and Method: Between September 1984 and December 2004, 34 patients underwent surgical treatment. Mean age of patients was $17.1\pm15.2$ years and 19 patients $(55.9\%)$ were male, 16 patients $(47.1\%)$ had previous operations and associated diseases were aortic regurgitation (11), coarctation of aorta (3), and others. Result: Immediate postoperative peak pressure gradient was significantly lower than preoperative peak pressure gradient (21.8 mmHg vs 75.8 mmHg, p<0.04). Peak pressure gradient measured after 50.3 months of follow up was 20.2 mmHg which was also significantly lower than that of preoperative value but not significantly different from that of immediate postoperative value. There was no surgical mortality but one patient developed cerebral infarction. Mean follow up duration was $69.8\pm54.6\;months$. During this period, 5 patients $(14.7\%)$ had reoperation, 3 $(8.8\%)$ of whom were due to recurred subaortic stenosis. We found no risk factors for recurrence and survival for free from reoperation was $76.4\%$. Conclusion: Excision of subaortic membrane combined with or without myectomy in discrete subaortic stenosis showed sufficient relief of left ventricular outflow tract obstruction with low mortality and morbidity, but careful long term follow up is necessary for recurrence, since it is not predictable.
Keywords
Ventriculr outflow tract obstruction, left; Aortic stenosis, subvalvulr; Ventricel; Surgical operation;
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