• Title/Summary/Keyword: Aortic stenosis, subvalvulr

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Discrete Membranous Subvalvulr Aortic Stenosis - A Case - (분리된 막성 대동맥 판막하 협착증;1례 보고)

  • 오중환
    • Journal of Chest Surgery
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    • v.25 no.7
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    • pp.739-744
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    • 1992
  • Discrete membranous subaortic stenosis[DMSS] is one of the subtype of congenital left ventricular outflow obstruction and can be associated with aortic regurgitation, infective endocarditis, ventricular obstruction. DMSS should be removed early, when diagnosed, and completely before secondary myocardial changes occur. Recently we experienced a case of DMSS with aortic regurgitation, and its left ventricular outflow tract obstruction[LVOTO] peak systolic gradient was 10lmmHg. Resection of membrane and aortic valve replacement is adequet for LVOTO and postoperative pressure gradient was 26mmHg. Postoperative echocardiogram shows no obstuctive membrane and well functioning aortic valve.

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Clinical Analysis of Surgical Results for Discrete Subaortic Stenosis (분리 대동맥판막하 협착증 수술의 임상적 고찰)

  • Yu Song Hyeon;Lim Sang Hyun;Hong You Sun;Park Young Hwan;Chang Byung Chul;Kang Meyun Shick
    • Journal of Chest Surgery
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    • v.38 no.8 s.253
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    • pp.545-550
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    • 2005
  • 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.