Author:
Shem-Tov A,Schneeweiss A,Motro M,Neufeld H N
Abstract
We report 21 patients with discrete subaortic stenosis (DSS) causing mild obstruction with a peak systolic left ventricular outflow pressure gradients less than 50 mm Hg. They were followed 1--17 years (mean 6.5 years), and eight were recatheterized before surgery, 2--17 years after the first cardiac catheterization. Three patients (14%) had subacute bacterial endocarditis. Ten (48%) had aortic insufficiency, one of whom had no pressure gradient across the left ventricular outflow tract. In three of the 10 patients, aortic insufficiency was found only at the second catheterization. Nine patients (43%) had hyperactive, asymmetric left ventricular contraction; in three, this finding was present only at the second catheterization. Seven of the eight patients who were recatheterized (33% of the entire group) showed an increase in gradient. The increase was from a mean gradient of 35.2 mm Hg to 76.7 mm Hg. Seventeen patients (81%) had at least one of these four features. In view of these data, we suggest that surgical indications for DSS might be expanded, although definitive recommendations are not possible. All cases of DSS should be carefully followed. Surgery should be performed if signs of progressive complications develop.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference21 articles.
1. Subaortic Stenosis (Discrete Form)
2. Shem-Tov AA. Deutsch V Yahini JH Schneeweiss A Neufeld HN: Discrete subaortic stenosis associated with hypertrophic subaortic stenosis. Presented at the World Congress of Paediatric Cardiology London 1980
3. Congenital discrete subvalvular aortic stenosis. Surgical experience and long-term followup in 20 paediatric patients;Champsaur G;Br Heart J,1974
Cited by
78 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献