Discrete subaortic stenosis: Incidence, morphology and surgical impact of associated subaortic anomalies

Maurizio Marasini, Lucio Zannini, Gian Paolo Ussia, Robin Pinto, Rodolfo Moretti, Franco Lerzo, Giacomo Pongiglione

Research output: Contribution to journalArticle

Abstract

Background. The association between discrete subaortic 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 surgical impact of associated anomalies of the left ventricular outflow tract in children operated on for discrete subaortic stenosis. Methods. Between 1994 and 2000, 45 consecutive children 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 subaortic 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 papillary muscle (2 cases); anomalous muscular band (8 cases); and muscularization of the anterior mitral valve leaflet (1 case). Cardiopulmonary bypass and aortic crossclamping 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 significant 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 obstruction without any increase in mortality and morbidity.

Original languageEnglish
Pages (from-to)1763-1768
Number of pages6
JournalAnnals of Thoracic Surgery
Volume75
Issue number6
DOIs
Publication statusPublished - Jun 1 2003

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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