The Journal of Thoracic and Cardiovascular Surgery, Vol 74, 352-361, Copyright © 1977 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Discrete subvalvular aortic stenosis. An evaluation of operative therapy
RL Hardesty, BP Griffith, RA Mathews, RD Siewers, WH Neches, SC Park and HT Bahnson
Angiocardiographic and operative observations support the validity of
classifying the spectrum of congenital subvalvular aortic stenosis into a
membrane, fibromuscular collar, and tunnel. Our current operative method is
to excise a thin membrane or thick fibrous ridge, and, if a fibromuscular
collar or tunnel is identified, to effect a left ventricular myomectomy as
described by Morrow for hypertrophic subaortic stenosis. Data from
experience with 35 children indicate that this approach is effective and
safe. Gradients are substantially reduced and residual obstruction
acceptable. Successive clinical evaluations (100 percent of 33 survivors)
over an interval of 1 to 13 years (mean of 6) affirm that amelioration of
the obstruction endures.
