Document Detail

Fate of patients with fixed subaortic stenosis after surgical removal.
MedLine Citation:
PMID:  7191709     Owner:  NLM     Status:  MEDLINE    
Thirty-nine consecutive patients, aged 5 to 57 years, were followed for two to 15 years with serial haemodynamic studies after removal of fixed subaortic stenosis, which was never a "membrane". Two late deaths occurred, one sudden and one in congestive failure. Of 37 survivors, 25 were asymptomatic and could be classified as good or excellent if judged by well-being. Seven were symptomatic, two having had reoperation for fixed subaortic stenosis, and four needed long-term pacing. Evaluation, including the effect of isoprenaline, showed important dynamic obstruction in 17, five of whom redeveloped fixed obstruction. Seven had congestive features without outflow gradients, and 14 had neither congestion nor outflow obstruction. Complete assessment therefore confirmed that only 14 (36%) were haemodynamically satisfactory; two of them had permanent pacing, and four had had aortic valve surgery. Fixed subaortic stenosis should be removed early, when diagnosed, and completely before secondary myocardial changes occur. Patients however "well" need regular supervision and early haemodynamic assessment. The aortic valve, whether repaired, replaced, or untouched, remains a site for infective endocarditis for life. The fixed subaortic stenosis removed at operation may not be present in that form at birth, but acquired secondary to other congenital abnormalities which remain in the patient.
J Somerville; S Stone; D Ross
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  43     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1980 Jun 
Date Detail:
Created Date:  1981-01-26     Completed Date:  1981-01-26     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  629-47     Citation Subset:  AIM; IM    
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MeSH Terms
Aortic Stenosis, Subvalvular / complications,  physiopathology,  surgery*
Cardiomyopathy, Hypertrophic / surgery*
Child, Preschool
Follow-Up Studies
Heart Defects, Congenital / complications
Isoproterenol / diagnostic use
Middle Aged
Postoperative Complications / physiopathology
Pregnancy Complications, Cardiovascular
Reg. No./Substance:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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