Surgery for discrete subvalvular aortic stenosis: Actuarial survival, hemodynamic results, and acquired aortic regurgitation

John Brown, L. Stevens, L. Lynch, R. Caldwell, D. Girod, R. Hurwitz, L. Mahony, H. King

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

Discrete membranous subaortic stenosis (DMSS) accounts for 8 to 30% of congenital left ventricular outflow obstruction. The immediate effectiveness of surgical resection of this discrete obstructing membrane has been well documented, but little has appeared regarding late clinical and hemodynamic follow-up. Fifty-three patients with DMSS underwent operation at our institution from 1957 to 1983. Most (78%) were symptomatic, 79% had left ventricular hypertrophy (LVH) by electrocardiogram, and 92% had roentgenographic evidence of cardiomegaly preoperatively. Catheterization revealed a mean preoperative left ventricular-aortic gradient of 89 mm Hg. Twenty-eight patients had associated aortic insufficiency (AI) on the initial aortogram. Seven patients acquired AI in the interim between the first and second preoperative catheterization. Our patients have been followed for up to 12 years postoperatively. There have been 2 early and 3 late deaths. (Actuarial analysis revealed 5- and 10-year survival of 95% and 83%, respectively). Seventy-one percent of the previously symptomatic patients noted relief of their preoperative complaints, and 45% of those with LVH had a regression in voltage. Cardiomegaly as determined by chest roentgenogram decreased in 45%. The left ventricular-aortic gradient fell to an average of 35 mm Hg a year postoperatively. Surgical treatment of congenital subvalvular aortic stenosis is effective in reducing the preoperative symptoms and the left ventricular-aortic gradient. It appears that DMSS causes AI.

Original languageEnglish
Pages (from-to)151-155
Number of pages5
JournalAnnals of Thoracic Surgery
Volume40
Issue number2
StatePublished - 1985

Fingerprint

Subvalvular Aortic Stenosis
Aortic Valve Insufficiency
Discrete Subaortic Stenosis
Hemodynamics
Survival
Cardiomegaly
Left Ventricular Hypertrophy
Catheterization
Actuarial Analysis
Ventricular Outflow Obstruction
Electrocardiography
Thorax
Membranes
Membranous Subaortic Stenosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Surgery for discrete subvalvular aortic stenosis : Actuarial survival, hemodynamic results, and acquired aortic regurgitation. / Brown, John; Stevens, L.; Lynch, L.; Caldwell, R.; Girod, D.; Hurwitz, R.; Mahony, L.; King, H.

In: Annals of Thoracic Surgery, Vol. 40, No. 2, 1985, p. 151-155.

Research output: Contribution to journalArticle

Brown, J, Stevens, L, Lynch, L, Caldwell, R, Girod, D, Hurwitz, R, Mahony, L & King, H 1985, 'Surgery for discrete subvalvular aortic stenosis: Actuarial survival, hemodynamic results, and acquired aortic regurgitation', Annals of Thoracic Surgery, vol. 40, no. 2, pp. 151-155.
Brown, John ; Stevens, L. ; Lynch, L. ; Caldwell, R. ; Girod, D. ; Hurwitz, R. ; Mahony, L. ; King, H. / Surgery for discrete subvalvular aortic stenosis : Actuarial survival, hemodynamic results, and acquired aortic regurgitation. In: Annals of Thoracic Surgery. 1985 ; Vol. 40, No. 2. pp. 151-155.
@article{e810d678dc4042fd915927cc9ba1897a,
title = "Surgery for discrete subvalvular aortic stenosis: Actuarial survival, hemodynamic results, and acquired aortic regurgitation",
abstract = "Discrete membranous subaortic stenosis (DMSS) accounts for 8 to 30{\%} of congenital left ventricular outflow obstruction. The immediate effectiveness of surgical resection of this discrete obstructing membrane has been well documented, but little has appeared regarding late clinical and hemodynamic follow-up. Fifty-three patients with DMSS underwent operation at our institution from 1957 to 1983. Most (78{\%}) were symptomatic, 79{\%} had left ventricular hypertrophy (LVH) by electrocardiogram, and 92{\%} had roentgenographic evidence of cardiomegaly preoperatively. Catheterization revealed a mean preoperative left ventricular-aortic gradient of 89 mm Hg. Twenty-eight patients had associated aortic insufficiency (AI) on the initial aortogram. Seven patients acquired AI in the interim between the first and second preoperative catheterization. Our patients have been followed for up to 12 years postoperatively. There have been 2 early and 3 late deaths. (Actuarial analysis revealed 5- and 10-year survival of 95{\%} and 83{\%}, respectively). Seventy-one percent of the previously symptomatic patients noted relief of their preoperative complaints, and 45{\%} of those with LVH had a regression in voltage. Cardiomegaly as determined by chest roentgenogram decreased in 45{\%}. The left ventricular-aortic gradient fell to an average of 35 mm Hg a year postoperatively. Surgical treatment of congenital subvalvular aortic stenosis is effective in reducing the preoperative symptoms and the left ventricular-aortic gradient. It appears that DMSS causes AI.",
author = "John Brown and L. Stevens and L. Lynch and R. Caldwell and D. Girod and R. Hurwitz and L. Mahony and H. King",
year = "1985",
language = "English",
volume = "40",
pages = "151--155",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "2",

}

TY - JOUR

T1 - Surgery for discrete subvalvular aortic stenosis

T2 - Actuarial survival, hemodynamic results, and acquired aortic regurgitation

AU - Brown, John

AU - Stevens, L.

AU - Lynch, L.

AU - Caldwell, R.

AU - Girod, D.

AU - Hurwitz, R.

AU - Mahony, L.

AU - King, H.

PY - 1985

Y1 - 1985

N2 - Discrete membranous subaortic stenosis (DMSS) accounts for 8 to 30% of congenital left ventricular outflow obstruction. The immediate effectiveness of surgical resection of this discrete obstructing membrane has been well documented, but little has appeared regarding late clinical and hemodynamic follow-up. Fifty-three patients with DMSS underwent operation at our institution from 1957 to 1983. Most (78%) were symptomatic, 79% had left ventricular hypertrophy (LVH) by electrocardiogram, and 92% had roentgenographic evidence of cardiomegaly preoperatively. Catheterization revealed a mean preoperative left ventricular-aortic gradient of 89 mm Hg. Twenty-eight patients had associated aortic insufficiency (AI) on the initial aortogram. Seven patients acquired AI in the interim between the first and second preoperative catheterization. Our patients have been followed for up to 12 years postoperatively. There have been 2 early and 3 late deaths. (Actuarial analysis revealed 5- and 10-year survival of 95% and 83%, respectively). Seventy-one percent of the previously symptomatic patients noted relief of their preoperative complaints, and 45% of those with LVH had a regression in voltage. Cardiomegaly as determined by chest roentgenogram decreased in 45%. The left ventricular-aortic gradient fell to an average of 35 mm Hg a year postoperatively. Surgical treatment of congenital subvalvular aortic stenosis is effective in reducing the preoperative symptoms and the left ventricular-aortic gradient. It appears that DMSS causes AI.

AB - Discrete membranous subaortic stenosis (DMSS) accounts for 8 to 30% of congenital left ventricular outflow obstruction. The immediate effectiveness of surgical resection of this discrete obstructing membrane has been well documented, but little has appeared regarding late clinical and hemodynamic follow-up. Fifty-three patients with DMSS underwent operation at our institution from 1957 to 1983. Most (78%) were symptomatic, 79% had left ventricular hypertrophy (LVH) by electrocardiogram, and 92% had roentgenographic evidence of cardiomegaly preoperatively. Catheterization revealed a mean preoperative left ventricular-aortic gradient of 89 mm Hg. Twenty-eight patients had associated aortic insufficiency (AI) on the initial aortogram. Seven patients acquired AI in the interim between the first and second preoperative catheterization. Our patients have been followed for up to 12 years postoperatively. There have been 2 early and 3 late deaths. (Actuarial analysis revealed 5- and 10-year survival of 95% and 83%, respectively). Seventy-one percent of the previously symptomatic patients noted relief of their preoperative complaints, and 45% of those with LVH had a regression in voltage. Cardiomegaly as determined by chest roentgenogram decreased in 45%. The left ventricular-aortic gradient fell to an average of 35 mm Hg a year postoperatively. Surgical treatment of congenital subvalvular aortic stenosis is effective in reducing the preoperative symptoms and the left ventricular-aortic gradient. It appears that DMSS causes AI.

UR - http://www.scopus.com/inward/record.url?scp=0021971738&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021971738&partnerID=8YFLogxK

M3 - Article

C2 - 3161465

AN - SCOPUS:0021971738

VL - 40

SP - 151

EP - 155

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 2

ER -