Résumé
Abstract This paper presents a case study of a 30-year-old male patient with dyspnea on exertion had echocardiographic diagnosis of aortic subvalvar stenosis. Discrete mitral regurgitation and aortic valve dysplasia with mild to moderate insufficiency and hypertrophic cardiomyopathy were also noted. During surgery, a rare condition was identified: presence of papillary muscle anomaly associated with the subaortic membrane as a cause of obstruction of the left ventricular outflow tract. With the resection of these structures and a mitral valve annuloplasty, the patient evolved with a significant improvement of clinical condition and heart failure, with no residual mitral insufficiency.
Sujets)
Humains , Mâle , Adulte , Muscles papillaires/malformations , Obstacle à l'éjection ventriculaire/chirurgie , Rétrécissement aortique sous-valvulaire modéré/complications , Cardiopathies congénitales/complications , Muscles papillaires/chirurgie , Obstacle à l'éjection ventriculaire/étiologie , Échocardiographie , Rétrécissement aortique sous-valvulaire modéré/chirurgie , Rétrécissement aortique sous-valvulaire modéré/imagerie diagnostique , Annuloplastie mitrale , Cardiopathies congénitales/chirurgie , Cardiopathies congénitales/imagerie diagnostiqueRésumé
We herein report a rare case of subaortic stenosis in association with a previous tetralogy of Fallot (TOF) surgical repair, which was not taken into account as a differential diagnosis. Echocardiography plays a pivotal role in identification of this rare combination. Therefore, echocardiography should be performed periodically during follow-up of patients with surgically corrected TOF. Given the clinical complications that can result from subaortic stenosis (i.e., aortic regurgitation and infective endocarditis), early and aggressive management of this rare combination should be performed.