Subvalvar aortic stenosis: Timing of operation

E. Charles Douville, Robert M. Sade, Fred A. Crawford, Henry B. Wiles

Research output: Contribution to journalArticle

51 Citations (Scopus)

Abstract

Subvalvar aortic stenosis can be associated with progressive left ventricular outflow tract obstruction, aortic insufficiency, and infective endocarditis. We reviewed the records of 36 surgical patients who underwent 39 operations for subaortic stenosis. Seventeen patients had associated congenital cardiac anomalies. One perioperative death occurred in a patient with tetralogy of Fallot. The mean preoperative left ventricular outflow tract systolic pressure gradient was 64 ± 5 mm Hg (± standard error of the mean) and decreased to 9 ± 2 mm Hg postoperatively (p < 0.001). Reliable preoperative and postoperative information regarding aortic valve function was available for 27 patients. Aortic insufficiency was found in 17 (63%) of those patients preoperatively. Postoperatively, insufficiency increased in 3 patients and decreased in 4; none of these changes was major. Severity of preoperative aortic insufficiency increased significantly with age (p < 0.05), but did not correlate with left ventricular outflow tract gradient. The information from this study and previous studies suggests that resection of subaortic stenosis is safe and effective, and operation at the time of diagnosis, regardless of left ventricular outflow tract gradient or symptomatic status, is a reasonable therapeutic alternative.

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalThe Annals of Thoracic Surgery
Volume50
Issue number1
DOIs
StatePublished - Jul 1990

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Aortic Valve Stenosis
Pathologic Constriction
Ventricular Outflow Obstruction
Tetralogy of Fallot
Endocarditis
Aortic Valve
Blood Pressure

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Subvalvar aortic stenosis : Timing of operation. / Douville, E. Charles; Sade, Robert M.; Crawford, Fred A.; Wiles, Henry B.

In: The Annals of Thoracic Surgery, Vol. 50, No. 1, 07.1990, p. 29-33.

Research output: Contribution to journalArticle

Douville, E. Charles ; Sade, Robert M. ; Crawford, Fred A. ; Wiles, Henry B. / Subvalvar aortic stenosis : Timing of operation. In: The Annals of Thoracic Surgery. 1990 ; Vol. 50, No. 1. pp. 29-33.
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