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

ABSTRACT

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