RESUMO
Objective A retrospective study of patients in the past ten years who underwent surgeries because of secondary subaortic stenosis(SSS) after previous repair of congenital heart disease(CHD) was performed.The anatomy,indication,and surgical outcomes were studied.Methods Between January 2004 and October 2013,forty-eight patients underwent surgeries because of SSS.Thirty-five patients were males,and 13 were females.The mean age was(54.0 ± 34.9) months (12-156 months).The mean weight was(16.1 ±6.2)kg(6.0-37.5 kg).And the mean interval between the first and second surgery was(39.6 ±25.0) months(11-115 months).The primary diagnosis of CHD included ventricular septal defect,double outlet of right ventricle,corctation,interruption of aortic arch,patent trucus arteriosus,atrio-ventricular defect,tetralogy of fallot,transposition of great arteries,and univentricle.Results Twenty-five patients were discrete subaortic stenosis,and had the fibromuscular ridge resected.Twenty-three patients were diffuse type of subaortic stenosis.Myectomy,reconstruction of the intraventricular baffle,and modified Konno procedure were done in 8,5,and 10 patients separately.One patient died of cardiac failure postoperatively.One developed complete left bundle branch block,and another one developed complete atrioventricular block.The pressure gradients dropped from(76.8 ±20.4)mmHg to(12.4 ±8.4)mmHg,P ＜0.001.One patient was lost in follow-up and the left 46 patients had been followed up for 27 ～ 144 months [mean (59.6 ± 28.3) months] with no late death.The recent echocardiography results showed that the pressure gradients were(16.3 ± 15.2) mmHg.Five patients required reoperations due to recurrence of stenosis and the freedom from reoperation was 82.8％ at 10 years.Conclusion Earlier diagnosis and intervention is recommended for SSS,and excellent relief can be achieved.
RESUMO
Objective A retrospective study of patients in the past ten years who underwent surgeries because of secondary subaortic stenosis(SSS) after previous repair of congenital heart disease(CHD) was performed.The anatomy,indication,and surgical outcomes were studied.Methods Between January 2004 and October 2013,forty-eight patients underwent surgeries because of SSS.Thirty-five patients were males,and 13 were females.The mean age was(54.0 ± 34.9) months (12-156 months).The mean weight was(16.1 ±6.2)kg(6.0-37.5 kg).And the mean interval between the first and second surgery was(39.6 ±25.0) months(11-115 months).The primary diagnosis of CHD included ventricular septal defect,double outlet of right ventricle,corctation,interruption of aortic arch,patent trucus arteriosus,atrio-ventricular defect,tetralogy of fallot,transposition of great arteries,and univentricle.Results Twenty-five patients were discrete subaortic stenosis,and had the fibromuscular ridge resected.Twenty-three patients were diffuse type of subaortic stenosis.Myectomy,reconstruction of the intraventricular baffle,and modified Konno procedure were done in 8,5,and 10 patients separately.One patient died of cardiac failure postoperatively.One developed complete left bundle branch block,and another one developed complete atrioventricular block.The pressure gradients dropped from(76.8 ±20.4)mmHg to(12.4 ±8.4)mmHg,P ＜0.001.One patient was lost in follow-up and the left 46 patients had been followed up for 27 ～ 144 months [mean (59.6 ± 28.3) months] with no late death.The recent echocardiography results showed that the pressure gradients were(16.3 ± 15.2) mmHg.Five patients required reoperations due to recurrence of stenosis and the freedom from reoperation was 82.8％ at 10 years.Conclusion Earlier diagnosis and intervention is recommended for SSS,and excellent relief can be achieved.
RESUMO
The population of adult patients with congenital heart disease(CHD) has increased dramatically because of improved survival of infants and children with CHD. There are still a substantial number of adults with unrepaired CHD. Many adult patients do not know the possible problems of their disease such as ventricular dysfunction, arrhythmia, and what they should pay attention to. They often consider themselves "cured" or "healthy" if only they don't have overt symptoms, and visit hospitals only after deterioration of their problems. Some patients are neglected because they cannot be corrected surgically although careful medical support can improve their survival and quality of life. It is, therefore, essential that the patients, their families, and physicians understand the potential problems of CHD and need for regular follow-up. In this paper we will take a brief review for common medical problems of repaired or unrepaired CHD and also mention a few specific diseases which are common in adults.
