Surgical results in subaortic stenosis

Risk Factors for Reoperation After Repair of Discrete Subaortic Stenosis in Children

“…The lesion is rarely clinically apparent in infancy, but the gradient across the obstruction increases progressively in approximately 50% of patients (2). Left untreated, progressive DSS can lead to left ventricular hypertrophy and eventual failure, arrhythmias, aortic valve regurgitation, and endocarditis (3)(4)(5)(6). Although surgery is effective in the majority of patients, recurrence occurs in 0% to 55% (7)(8)(9)(10)(11)(12), and reoperation is required in a fraction of those.…”

Long-term outcomes and risk factors for aortic regurgitation after discrete subvalvular aortic stenosis resection in children

“…While the overall rate of reoperation for DSS has been reported by several groups,1 3 6 8 10–13 16 17 24–27 lack of long-term follow-up has limited the examination of the time course of reoperation after initial resection. The rate of reoperation in our cohort is consistent with prior reports and slightly higher than our 2007 analysis, as might be expected with a longer follow-up period 4 10–12 14 23 24 27.…”

Fixed Subaortic Stenosis: A Clinical Dilemma for Clinicians and Patients

“…Patients are usually asymptomatic, but over time may develop symptoms of LVOT obstruction. In one study of children and adults (mean 13 years old), 54% of patients were New York Heart Association class II or III at the time of surgery . Symptoms included dyspnea, chest pain at rest or with exertion, syncope, and palpitations.…”

“…found a 48% rate of aortic regurgitation, with a significant number sustaining infectious endocarditis, Attie et al. recommended surgery at diagnosis regardless of severity of obstruction . Somerville et al.…”

“…There are many single‐center studies assessing the short and long‐term outcome of surgical intervention for SAS . The difficulty in assessing the data is that most studies are small, surgical indications, and surgical technique has varied between institutions and has changed over time.…”