title: Long-term outcome of patients with isolated thin discrete subaortic stenosis treated by balloon dilation: a 25-year study.
abstract: BACKGROUND
  Transluminal balloon tearing of the membrane in a thin discrete subaortic stenosis is an alternative to membrane surgical resection. However, the long-term outcome of patients with isolated thin discrete subaortic stenosis treated by transluminal balloon tearing remains unknown.
  
  
  RESULTS
  This 25-year study describes findings from 76 patients with isolated thin discrete subaortic stenosis who underwent percutaneous transluminal balloon tearing of the membrane and were followed up for a mean period of 16±6 years. The age at presentation had a wide range (2-67 years). The mean age at treatment was 19±16 years. Immediately after treatment, the subvalvular gradient decreased from 70±27 to 18±12 mm Hg (P<0.001). No significant postprocedural aortic regurgitation was observed. After a mean follow-up time of 16±6 years, 11 patients (15%) developed restenosis, 3 patients (4%) progressed to muscular obstructive disease, and 1 patient (1.3%) developed a new distant obstructive membrane. Twelve patients (16%) were redilated at a mean of 5±3 years after their first treatment, and 4 patients (5%) underwent surgery at a mean of 3±2 years after their first treatment. Fifty-eight patients (77%) remained alive and free of redilation or surgery at follow-up. Larger annulus diameter and thinner membranes were independent factors associated with better long-term results.
  
  
  CONCLUSIONS
  Most patients (77%) with isolated thin discrete subaortic stenosis treated with transluminal balloon tearing of the membrane had sustained relief at subsequent follow-ups without restenosis, the need for surgery, progression to muscular obstructive disease, or an increase in the degree of aortic regurgitation.
authors.affiliation: Instituto Maimónides de Investigación Biomédica de Córdoba, University Hospital Reina Sofía, Avda Menéndez Pidal s/n, 14004-Córdoba, Spain. grupo_corpal@arrakis.es
authors.forename: José Suárez
authors.initials: JS
authors.lastname: de Lezo
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.forename: José
authors.initials: J
authors.lastname: Segura
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.forename: Javier Suárez
authors.initials: JS
authors.lastname: de Lezo
authors.forename: Djordje
authors.initials: D
authors.lastname: Pavlovic
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.forename: Mónica
authors.initials: M
authors.lastname: Delgado
authors.forename: Dolores
authors.initials: D
authors.lastname: Mesa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000800:Angioplasty, Balloon / Q000379:methods*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006439:Hemodynamics; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult