CASE REPORT ON SURGICAL EXCISION OF DISCRETE MEMBRANEOUS SUB AORTIC STENOSIS
A 7 years old boy presented Cardiac Center of Ethiopia (CCE) with dyspnea on exertion. His chest X ray showed evidence of cardiomegaly and his electrocardiography (ECG) showed left ventricular hypertrophy (LVH). His Doppler 2D echocardiography revealed that there is a discrete sub aortic membrane and gradient in the left ventricular out flow tract (LVOT) was 80mmHG.
Using trans-aortic approach, excision of the sub aortic membrane done. Post-operative the heart picked up in sinus rhythm and weaning from cardiopulmonary bypass was routine. Epicardial Doppler echocardiography showed mean gradient across LVOT of 19mmHG. LVOT was also shown free from remnant membrane. The patient got discharged from hospital on the fifth day.
Keywords: Discrete membranous sub aortic stenosis, surgical excision,congenital heart diseaseÂ
. Fink BW Aortic stenosis and other lesions obstructive to the left ventricular outflow. In Congenital Heart Disease. Chicago, Year Book, 1975, pp 42-54
Oldham HN Jr: Congenital aortic stenosis. In Sabiston DC Jr (ed): Tactbook of Surgery: The Biological Basis of Modem Surgical Practice. Philadelphia, Saunders, 1981, pp 2301-2311.
Newfeld EA, Muster AJ, Paul MH, Idriss FS, Riker WL. Discrete sub valvar aortic stenosis in childhood. Am J Cardiol 1976;38:53-61
Somerville J, Stone S, Ross D. Fate of patients with fixed subaortic stenosis after surgical removal. Br Heart J 1980;43: 62947.
Freedom RM, Fowler RS, Duncan WJ. Rapid evolution of "normal" left ventricular outflow tract to fatal subaortic stenosis in infancy. Br Heart J 1981;45:605-9.
Somerville J, Stone S, Ross D. Fate of patients with fixed subaortic stenosis after surgical removal. Br Heart J 1980;43: 629-47
Wright GB, Keane JF, Nadas AS, Bernhard WF, Castaneda AR. Fixed subaortic stenosis in the young: medical and surgical course in 83 patients. Am J Cardiol 1983;52:830-5.
Douville EC, Sade RM, Crawford FA Jr, Wiles HB. Subvalvaraortic stenosis: timing of operation. Ann ThoracSurg 1990; 50:29-34.
Jaumin P, Rubay J, Lintermans J, et al. Surgical treatment of subvalvularaorticstenosis. Long-termresults. J CardiovascSurg 1990;31:31-5.
Serraf A, Zoghby J, Lacour-Gayet F, et al. Surgical treatment of subaortic stenosis: a seventeen-year experience. J ThoracCardiovasc Surg 1999;117:669 â€“78.