The surgical treatment of fixed subaortic stenosis: A clinical experience in Japan
| Autor: | Goto Tetsuya, Yoshihisa Nakao, Ryo Aeba, Yoshito Inoue, Katsumi Moro, Shiaki Kawada, Toshiyuki Katogi, Ryohei Yozu, Tadashi Omoto, Yasunori Cho, Shigeyuki Takeuchi, Tsutomu Ito |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Reoperation Aortic valve Myotomy medicine.medical_specialty Adolescent medicine.medical_treatment Asymptomatic Lesion Japan Aortic valve replacement Internal medicine medicine Humans Child Retrospective Studies Cardiac catheterization business.industry Infant Retrospective cohort study Aortic Valve Stenosis General Medicine medicine.disease Surgery medicine.anatomical_structure Aortic Valve Child Preschool Infective endocarditis Cardiology Female medicine.symptom business |
| Zdroj: | Surgery Today. 29:317-321 |
| ISSN: | 1436-2813 0941-1291 |
| DOI: | 10.1007/bf02483055 |
| Popis: | We report herein the results of a retrospective study conducted on ten consecutive Japanese patients who underwent successful surgical relief of fixed subaortic stenosis between 1972 and 1994 at ages ranging from 8 months to 21 years, and followed for 3.6 years and 26 years. Associated cardiovascular defects were present in six patients, two had a history of infective endocarditis, a discrete fibrous ring was found in nine patients, and a redundant abnormal sheet was found in one. A stenotic structure was removed in nine patients and incised in one, while myotomy was additionally performed in one. There were no early complications or deaths. Cardiac catheterization revealed a significant decrease in the peak systolic pressure gradient from 84+/-22 mm Hg preoperatively to 32+/-22 mm Hg postoperatively (P = 0.0017). Reoperation of an aortic valve replacement with or without valvular annulus enlargement was required in four patients because of a small annulus with aortic insufficiency or infective endocarditis. Infective endocarditis was a major cause of late mortality (n = 1) and morbidity (n = 1), but the remaining eight patients have been asymptomatic. Thus, although this lesion is relatively rare in Japan, the typical discrete type may be more common than previously believed. While a relief operation is associated with low early mortality, the palliative aspect regarding pathology of the aortic valve should not be underestimated, including poor growth of the valve annulus, deterioration of aortic insufficiency, and infective endocarditis. The most appropriate operative procedure for reoperation remains to be evolved. |
| Databáze: | OpenAIRE |
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