| The Surgical History, Management, and Outcomes of Subaortic Stenosis in Adults. | |
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MedLine Citation:
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PMID: 22381443 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Subaortic stenosis (SAS) is a curtain of tissue involving the subaortic region, the aortic and mitral valves, the septum, and the fibrous trigones. Little is known of its course or the outcomes of its surgical management in adults. METHODS: We reviewed our experience of the surgical management of SAS in adults from 1999 to 2010. We divided patients into three groups: (1) those presenting for first-time SAS resection (6 patients, 4 male, median age of 46.9 ± 17 years, mean follow-up of 5 ± 2.7 years); (2) those requiring redo resection of SAS without organic aortic valve dysfunction (8 patients, 3 male, median age of 25.3 ± 5 years, mean follow-up of 8 ± 3.08 years); and (3) those with SAS and aortic valve dysfunction (8 patients, 4 males, median age of 34.8 ± 12 years, mean follow-up of 4.5 ± 2.5 years; 5 had previous SAS surgery). RESULTS: Patients underwent extensive excision of the SAS, release of the fibrous trigones, and a septal myectomy if required. There was 1 early death in group 2 and 1 in group 3. In group 3, 1 patient underwent the Ross procedure and 7 patients had mechanical valve implantation. No patient required permanent pacemaker implantation. Overall follow-up was 3.3 ± 3 years (range, 6 months to 10 years). The preoperative left ventricular outflow tract gradient ranged from 40 to 120 mm Hg, and the postoperative left ventricular outflow tract gradient ranged from 0 to 16 mm Hg. At latest follow-up, no patient in groups 1 or 2 had greater than mild native aortic regurgitation. CONCLUSIONS: Subaortic stenosis resection in adults can successfully relieve left ventricular outflow tract obstruction, with low mortality. The complexity of SAS increases with time; therefore a longer duration of follow-up is needed to further validate our conclusions. |
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Authors:
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Michael Ibrahim; Martin Kostolny; Tain-Yen Hsia; Carin Van Doorn; Fiona Walker; Shay Cullen; Magdi H Yacoub; Victor T Tsang |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-28 |
Journal Detail:
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Title: The Annals of thoracic surgery Volume: - ISSN: 1552-6259 ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-3-2 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 15030100R Medline TA: Ann Thorac Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Cardiothoracic Surgery, Great Ormond Street Hospital, London, United Kingdom; Heart Science Centre, Imperial College London, Harefield Hospital, London, United Kingdom. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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