Subaortic membrane in an adult patient with coronary artery disease

A case of subaortic membrane with coronary artery disease in a 48-year-old man is described. He was referred to our hospital for cardiac murmur, which was discovered on routine clinical examination. He had no significant past medical history apart from dizziness while exercising. Subaortic membrane was totally excised; left internal thoracic artery was anastomosed to left anterior descending artery by end-to-side technique. The postoperative 2-year course of the patient was uneventful

Effect of ventriculoseptal myectomy on surgical management of subaortic stenosis

In this study 29 cases of subaortic stenosis were analyzed to evaluate the value of septal myectomy in surgical management of subaortic stenosis. They were classified into 2 groups: Group I included 16 cases without myectomy and group II 13 cases for whom myectomy [in 10 cases] or myotomy [in 3 cases] was performed with excision of subaortic membrane of fibromuscular ridge. Immediate and late postoperative pressure gradient measurements across LVOT, showed smaller gradient in group II. There was more regression of the gradient during follow up visits in patients, for whom septal myectomy or myotomy was performed. Septal myectomy is recommended in cases of subaortic stenosis. The amount of resection is adjusted according to the degree of septal hypertrophy

Surgical experience with congenital fixed subaortic stenosis at the American university of Beirut medical center

Twenty-two cases of subaortic stenosis were operated upon at the American University of Beirut Medical Center [AUBMC] from1980 till 1987, and were follow-up for 3to78 months [average 38months], eighteen patients had a discrete subaortic membrane [group I] and 4 patients had a fibromuscular tunnel stenosis [group II]. The operative approach was transaortic under hypothermic cardioplegic myocardial arrest. No operative and no late death occurred. Two patients presented 4and 6months later with recurring symptoms and significant residual gradients in the left ventricular out flow tract, both have been controlled on medical treatment. The mean pre-operative gradients in groups I and II were 99.5 mm Hg and 110 mm Hg respectively; these dropped to 12.8 mm Hg and15mm Hg following correction. Five patients had associated aortic valve Insufficiency two patients a ventricular septal detect, one had a patent ductus arteriosus and another had an aneurysm of the sinus of valsalva together with aortic valve insufficiency. A review of the literature is included