Background. The association between discrete subaor- tic stenosis and other subaortic anomalies is a well known but rarely reported occurrence. The aim of this study is to define the incidence, morphology, and surgi- cal impact of associated anomalies of the left ventricular outflow tract in children operated on for discrete subaor- tic stenosis. Methods. Between 1994 and 2000, 45 consecutive chil- dren were operated on for discrete subaortic stenosis. Patients were divided in two groups according to the obstructive lesion detected by echocardiography. Results. A localized shelf was found as an isolated lesion in 31 patients (group A), whereas additional sub- aortic anomalies were found in 14 cases (31%) and were multiple in 5 cases (group B). The anomalies included anomalous septal insertion of mitral valve (7 cases); accessory mitral valve tissue (2 cases); anomalous papil- lary muscle (2 cases); anomalous muscular band (8 cases); nd muscularization of the anterior mitral valve leaflet (1 case). Cardiopulmonary bypass and aortic cross- clamping times were significantly shorter in group A. There were no operative deaths nor major complications or deaths during follow-up. A gradient of 15 mm Hg or more was found at follow-up in 5 cases whereas aortic regurgitation was estimated to be not clinically signifi- cant in all but 1 patient. Six cases of recurrent subaortic stenosis were found in our series, 3 of them with other subaortic anomalies. Conclusions. This study shows that discrete subaortic stenosis can often be associated with other subaortic abnormalities. Surgical treatment of these anomalies produces excellent early and mid-term relief of obstruc- tion without any increase in mortality and morbidity

DISCRETE SUBAORTIC STENOSIS: INCIDENCE, MORPHOLOGY AND SURGICAL IMPACT OF ASSOCIATED SUBAORTIC ANOMALIES

USSIA G;
2003-01-01

Abstract

Background. The association between discrete subaor- tic stenosis and other subaortic anomalies is a well known but rarely reported occurrence. The aim of this study is to define the incidence, morphology, and surgi- cal impact of associated anomalies of the left ventricular outflow tract in children operated on for discrete subaor- tic stenosis. Methods. Between 1994 and 2000, 45 consecutive chil- dren were operated on for discrete subaortic stenosis. Patients were divided in two groups according to the obstructive lesion detected by echocardiography. Results. A localized shelf was found as an isolated lesion in 31 patients (group A), whereas additional sub- aortic anomalies were found in 14 cases (31%) and were multiple in 5 cases (group B). The anomalies included anomalous septal insertion of mitral valve (7 cases); accessory mitral valve tissue (2 cases); anomalous papil- lary muscle (2 cases); anomalous muscular band (8 cases); nd muscularization of the anterior mitral valve leaflet (1 case). Cardiopulmonary bypass and aortic cross- clamping times were significantly shorter in group A. There were no operative deaths nor major complications or deaths during follow-up. A gradient of 15 mm Hg or more was found at follow-up in 5 cases whereas aortic regurgitation was estimated to be not clinically signifi- cant in all but 1 patient. Six cases of recurrent subaortic stenosis were found in our series, 3 of them with other subaortic anomalies. Conclusions. This study shows that discrete subaortic stenosis can often be associated with other subaortic abnormalities. Surgical treatment of these anomalies produces excellent early and mid-term relief of obstruc- tion without any increase in mortality and morbidity
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/20.500.12610/6052
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