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subaortic stenosis

Jagdish C Mohan, Madhu Shukla, Vishwas Mohan, Arvind Sethi
Although acquired left ventricular outflow obstruction has been reported in a variety of conditions, there are scant reports of its occurrence following mitral valve replacement (MVR). This study describes two female patients, who developed severe discrete subaortic stenosis, five years following MVR. In both cases, the mitral valve was replaced by a porcine Carpentier-Edwards 27-mm bioprosthesis with preservation of mitral valve leaflets. The risk of very late left ventricular outflow tract obstruction after bio-prosthetic MVR with preservation of subvalvular apparatus needs to be kept in mind in symptomatic patients...
September 2016: Indian Heart Journal
Ashwin Kodliwadmath, Vasudeva Naik, Shetty Shivakumar
No abstract text is available yet for this article.
January 2016: Journal of the Association of Physicians of India
Alain J Poncelet, Gébrine El Khoury, Laurent De Kerchove, Thierry Sluysmans, Stéphane Moniotte, Mona Momeni, Thierry Detaille, Jean E Rubay
OBJECTIVES: To analyse our institutional results in the setting of paediatric aortic valve (AV) repair. Primary end-points were overall survival, freedom from AV reoperation and freedom from AV replacement. METHODS: A retrospective analysis of all patients under 18 years of age operated on from 1977 to 2015 in a single tertiary care level institution. Patients were included if they benefited from any type of AV repair procedure, including commissurotomy, leaflet shaving or plication, or leaflet augmentation...
September 28, 2016: European Journal of Cardio-thoracic Surgery
Olivier Villemain, Damien Bonnet, Lucile Houyel, Mathieu Vergnat, Magalie Ladouceur, Virginie Lambert, Zakaria Jalal, Pascal Vouhé, Emre Belli
The management of double-outlet right ventricle associated with anatomically noncommitted ventricular septal defect constitutes a surgical challenge. The limits for, and the specific outcomes after anatomical vs univentricular repair still remain to be established. Between 1993 and 2011, 36 consecutive patients presenting with double-outlet right ventricle or noncommitted ventricular septal defect (21 inlet, 10 muscular, and 5 central perimembranous) and 2 adequately sized ventricles underwent surgical repair at 2 centers...
2016: Seminars in Thoracic and Cardiovascular Surgery
Tatsushi Onzuka, Shoji Morishige, Yoshiyuki Yamashita, Yasutaka Ueno
We report a case of aortic prosthetic valve endocarditis presenting with subaortic stenosis without perivalvular leakage and vegetations in the left ventricular outflow and right atrium, the latter being attached to the atrioventricular septum. Intraoperatively, an abscess that had formed on the aortic annulus and perforated to the right atrium was unexpectedly found, the fistula being occluded by vegetations. Even when no left-to-right shunts are detected by imaging, vegetations adjacent to the atrioventricular septum may conceal a left ventricle-right atrium fistula, resulting in prosthetic valve endocarditis presenting clinically as subaortic stenosis without perivalvular leakage...
September 2016: Annals of Thoracic Surgery
Lindsay R Freud, Gerald R Marx, Audrey C Marshall, Wayne Tworetzky, Sitaram M Emani
OBJECTIVES: Mitral valve replacement (MVR) in young children is limited by the lack of small prostheses. Our institution began performing MVR with modified, surgically placed, stented jugular vein grafts (Melody valve) in 2010. We sought to describe key echocardiographic features for pre- and postoperative assessment of this novel form of MVR. METHODS: The pre- and postoperative echocardiograms of 24 patients who underwent Melody MVR were reviewed. In addition to standard measurements, preoperative potential measurements of the mitral annulus were performed whereby dimensions were estimated for Melody sizing...
July 25, 2016: Journal of Thoracic and Cardiovascular Surgery
Julia S Donald, Phillip S Naimo, Yves d'Udekem, Malcolm Richardson, Andrew Bullock, Robert G Weintraub, Christian P Brizard, Igor E Konstantinov
BACKGROUND: Studies of long-term outcomes of discrete subaortic stenosis are rare. Therefore, we reviewed the long-term outcomes of fibromuscular resection in children with subaortic stenosis over 26 years from a single institution. METHODS: We conducted a retrospective review of all children (n=72) who underwent resection of subaortic obstruction for discrete subaortic stenosis between 1989 and 2015. RESULTS: Median age at surgery was 5.0 years (2...
July 19, 2016: Heart, Lung & Circulation
Patrick T Roughneen, Vincent R Conti
We report a 21-year-old patient with a ventricular septal defect (VSD) with an embolic vegetation on the tricuspid valve using a technique of septal leaflet detachment to facilitate the repair of the VSD. Although described in the pediatric patients, this technique has not been reported in adults. The technique of septal leaflet mobilization is described, along with other techniques of tricuspid leaflet mobilization that aid in VSD visualization and repair. Tricuspid leaflet detachment has application for adult surgeons repairing perimembranous, postinfarction, and iatrogenic VSD encountered in resection of subaortic stenosis...
August 2016: Annals of Thoracic Surgery
Inyoung Song, Jung Ah Park, Bo Hwa Choi, Sung Min Ko, Je Kyoun Shin, Hyun Keun Chee, Jun Seok Kim
OBJECTIVE: The aim of this study was to identify the morphological and functional characteristics of quadricuspid aortic valves (QAV) on cardiac computed tomography (CCT). MATERIALS AND METHODS: We retrospectively enrolled 11 patients with QAV. All patients underwent CCT and transthoracic echocardiography (TTE), and 7 patients underwent cardiovascular magnetic resonance (CMR). The presence and classification of QAV assessed by CCT was compared with that of TTE and intraoperative findings...
July 2016: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
David Luke Glancy
A decrease in left ventricular volume increases the severity of left ventricular outflow tract obstruction in patients with obstructive hypertrophic cardiomyopathy, formerly called idiopathic hypertrophic subaortic stenosis. Because of this, a musician with the condition develops dizziness playing his saxophone which requires repeated and prolonged Valsalva maneuvers.
September 1, 2016: American Journal of Cardiology
Tai Fuchigami, Masahiko Nishioka, Toru Akashige, Shotaro Higa, Kazuhiro Takahashi, Mami Nakayashiro, Taisuke Nabeshima, Arata Sashinami, Kenzo Sakurai, Kiyotaka Takefuta, Nobuhiro Nagata
OBJECTIVES: Bilateral pulmonary artery banding (bPAB) is utilized for some patients with a ventricular septal defect (VSD) and aortic coarctation (CoA) or interrupted aortic arch (IAA). We evaluated aortic valve (AoV) diameter and patient outcomes following bPAB. METHODS: Between August 2010 and September 2015, 10 consecutive patients with VSD and patent ductus arteriosus-dependent CoA or IAA underwent bPAB because of an AoV diameter of approximately <50% of the normal value (n = 6), severe subaortic stenosis and poor patient condition (n = 1, respectively), or low birthweight (n = 2)...
July 1, 2016: Interactive Cardiovascular and Thoracic Surgery
Neeraj K Ganju, Arvind Kandoria, Suresh Thakur, Sunite A Ganju
Shone's anomaly is a very rare congenital cardiac malformation characterized by four serial obstructive lesions of the left side of the heart (i) Supravalvular mitral membrane (ii) parachute mitral valve (iii) muscular or membranous subaortic stenosis and (iv) coarctation of aorta. We report a unique presentation of Shone's complex in a 14-year-old adolescent male. In addition to the four characteristic lesions the patient had bicuspid aortic valve, aneurysm of sinus of valsalva, patent ductus arteriosus, ventricular septal defect, persistent left superior vena cava opening into coronary sinus and severe pulmonary artery hypertension...
January 2016: Heart Views: the Official Journal of the Gulf Heart Association
Ramush Bejiqi, Hana Bejiqi, Ragip Retkoceri
BACKGROUND: Obstruction to the left ventricular outflow of the heart may be above the aortic valve (5%), at the valve (74%), or in the subvalvar region (23%). These anomalies represent 3 to 6% of all patients with congenital heart defects (CHD), and it occurs more often in males (male-female ratio of 4:1). AIM: The purpose of this study was to determine the sensitivity and specificity of transthoracic echocardiography in diagnosis of discrete subaortic membrane, to determine convenient time for surgical intervention, and for identifying involvement of the aortic valve by subaortic shelf...
March 15, 2016: Open Access Macedonian Journal of Medical Sciences
Selin Bayburt, Sahin Senay, Ahmet Umit Gullu, Muharrem Kocyigit, Gultekin Karakus, Mustafa Kemal Batur, Cem Alhan
Combined therapeutic approach with performing mitral valve repair may be necessitated for the treatment of idiopathic hypertrophic subaortic stenosis (IHSS) with systolic anterior motion. This report includes operative technique for combined robotic septal myectomy and mitral valve repair. A 45-year-old man with IHSS was admitted to our center for surgical intervention. The transthoracic echocardiography showed typical asymmetric ventricular hypertrophy. Left ventricle posterior wall thickness was 11 mm, and interventricular septum thickness was 21 mm...
March 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Juan Gu, Yunxia Cai, Bin Liu, Sheng Lv
BACKGROUND: We describe the anesthetic management for cesarean section in a pregnant woman with uncorrected double-outlet right ventricle. The anesthetic method, treatment of complications and lessons are discussed. CASE PRESENTATION: A 28-year-old woman visited our emergency room for progressive dyspnea and recurrent hemoptysis at 30 weeks' gestation. Her New York Heart Association functional class was III-IV. Echocardiography indicated that she had congenital heart disease of double-outlet right ventricle...
2016: SpringerPlus
Abdulraouf M Z Jijeh, Ahmad S Omran, Hani K Najm, Riyadh M Abu-Sulaiman
BACKGROUND: Intraoperative transesophageal echocardiography (TEE) has a major role in detecting residual lesions during and/or after pediatric cardiac surgery. METHODS: All pediatric patients who underwent cardiac surgery between July 2001 and December 2008 were reviewed. The records of surgical procedure, intraoperative TEE, and predischarge transthoracic echocardiograms were reviewed to determine minor and major residual cardiac lesions after surgical repair. RESULTS: During the study period, a total of 2268 pediatric cardiac patients were operated in our center...
April 2016: Journal of the Saudi Heart Association
Matthew F Pizzuto, Jeffrey D Zampi
A 6-month-old infant with Shone's complex was found to have left main coronary artery atresia during evaluation for recurrent subaortic stenosis with depressed left ventricular function. The ventricular function improved after surgical subaortic resection without coronary re-vascularisation. This case demonstrates first the rare finding of left main coronary artery atresia and second that coronary re-vascularisation is not necessarily required in all cases of left main coronary artery atresia.
June 2016: Cardiology in the Young
Anna Zlotina, Tatiana Nikulina, Natalia Yany, Olga Moiseeva, Tatiana Pervunina, Eugeny Grekhov, Anna Kostareva
BACKGROUND: Ring chromosome 18 [r(18)] syndrome represents a relatively rare condition with a complex clinical picture including multiple congenital dysmorphia and varying degrees of mental retardation. The condition is cytogenetically characterized by a complete or mosaic form of ring chromosome 18, with ring formation being usually accompanied by the partial loss of both chromosomal arms. Here we observed a 20-year-old male patient who along with the features typical for r(18) carriers additionally manifested a severe congenital subaortic stenosis...
2016: Molecular Cytogenetics
Armin Barekatain, Zaher Fanari, Sumaya Hammami, Wasif Qureshi
Obstruction of the left ventricular outflow tract (LVOT) occurs in six out of 10,000 live births. The obstruction occurs in the aortic valve level in 71 percent, in subvalvular level in 14 percent, and supravalvular level in 8 percent of cases. Subvalvular aortic stenosis (AS) can be either a fixed stenosis resulting from subaortic membrane or a dynamic stenosis because of hypertrophic cardiomyopathy. Here, we report a patient with subaortic membrane who became symptomatic in her sixth decade of life. Echocardiography is the preferred diagnostic modality...
November 2015: Delaware Medical Journal
Richard A Jonas
The introduction of prostaglandin E1 in the late 1970s revolutionized the management of interrupted aortic arch. Complete resuscitation should proceed over several days if necessary before surgery is undertaken. One-stage primary neonatal repair with direct arch anastomosis and ventricular septal defect closure is the preferred surgical approach. Selective cerebral perfusion with near-infrared monitoring is being used with increasing frequency. Although repair of interrupted arch is physiologically corrective, it should not be viewed as fully corrective because of the high incidence of important late left ventricular outflow tract obstruction...
2015: Seminars in Thoracic and Cardiovascular Surgery
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