title: Discrete subaortic stenosis: surgical outcomes and follow-up results.
abstract: Discrete subaortic stenosis, which is an obstructing lesion of the left ventricular outflow tract, remains a surgical challenge. The recurrence rate is high despite sufficient conventional resection. We retrospectively reviewed the results of surgery for discrete subaortic stenosis at our institution from September 1995 through March 2001. Twenty-one patients with this lesion underwent surgical treatment during this period. Excision of the fibromuscular membrane with myectomy was performed in all of the patients. Follow-up in all patients ranged from 7 to 67 months (mean follow-up period, 39.57 +/- 15.46 months). The mean systolic gradient between the left ventricle and the aorta decreased from 59.23 +/- 35.38 mmHg preoperatively to 9.47 +/- 9.91 mmHg postoperatively. There was no instance of heart block that required a permanent pacemaker, nor of bacterial endocarditis. There was no early or late postoperative death. A 22nd patient, who had 3+ aortic regurgitation, required aortic valve replacement and was excluded from the study. Two of the patients (9.5%) underwent reoperation because of recurrent gradient and residual ventricular septal defect. Our results suggest that fibromuscular membrane excision combined with myectomy in patients with discrete subaortic stenosis produces sufficient relief of obstruction with low morbidity.
authors.affiliation: Department of Cardiovascular Surgery, Ege University Hospital, Izmir, Turkey.
authors.forename: Osman Tansel
authors.initials: OT
authors.lastname: Darcin
authors.forename: Tahir
authors.initials: T
authors.lastname: Yagdi
authors.forename: Yuksel
authors.initials: Y
authors.lastname: Atay
authors.forename: Cagatay
authors.initials: C
authors.lastname: Engin
authors.forename: Erturk
authors.initials: E
authors.lastname: Levent
authors.forename: Suat
authors.initials: S
authors.lastname: Buket
authors.forename: Emin Alp
authors.initials: EA
authors.lastname: Alayunt
mesh_terms: D000293:Adolescent; D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D021922:Discrete Subaortic Stenosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006346:Heart Septum / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014463:Ultrasonography; D014694:Ventricular Outflow Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*