A 27-year-old woman developed subaortic stenosis 19 years after double-outlet right ventricle repair. Subaortic stenosis was caused by a narrow ring of fibromuscular ridge associated with a bulge of the underlying septal muscle. The aortic valve was bicuspid and stenotic. We conducted extended septoplasty, replacing the aortic valve. Postoperative cineangiogram showed an adequate left ventricular outflow pathway. Double-outlet right ventricle repair may thus be followed by subaortic stenosis as long as 19 years after initial surgery. This lesion was assumed due to acquired disease secondary to flow disturbances in the left ventricular outflow, so reconstructing an adequate outflow pathway is effective and appears to help avoid recurring stenosis.
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Reis RL, Peterson LM, Mason DT, Simon AL, Morrow AG. Congenital fixed subvalvular aortic stenosis. An anatomical classification and correlations with operative results. Circulation 1971; 43 (Suppl 1): 11–8.
Hardesty RL, Griffith BP, Mathews RA, Siewers RD, Neches WH, Park SC, et al. Discrete subvalvular aortic stenosis. An evaluation of operative therapy. J Thorac Cardiovasc Surg 1977; 74: 352–60.
Moses RD, Barnhart GR, Jones M. The late prognosis after localized resection for fixed (discrete and tunnel) left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg 1984; 87: 410–20.
Stewart JR, Merrill WH, Hammon JW Jr, Graham TP Jr, Bender HW Jr. Reappraisal of localized resection for subvalvar aortic stenosis. Ann Thorac Surg 1990; 50: 197–203.
Cicini MP, Giannico S, Marino B, Iorio FS, Corno A, Marcelletti C. “Acquired” subvalvular aortic stenosis after repair of a ventricular septal defect. Chest 1992; 101: 115–8.
Gewillig M, Daenen W, Dumoulin M, VanDer Hauwaert L. Rheologic genesis of discrete subvalvular aortic stenosis: a Doppler echocardiographic study. J Am Coll Cardiol 1992; 19: 818–24.
Belli E, Serraf A, Lacour-Gayet F, Inamo J, Houyel L, Bruniaux J, Planché C. Surgical treatment of subaortic stenosis after biventricular repair of double-outlet right ventricle. J Thorac Cardiovasc Surg 1996; 112: 1570–80.
Cooley DA, Garrett JR. Septoplasty for left ventricular outflow obstruction without aortic valve replacement: a new technique. Ann Thorac Surg 1986; 42: 445–8.
Kirklin JW, Barratt-Boyes BG. Congenital aortic stenosis. In: Kirklin JW, Barratt-Boyes BG, eds. Cardiac Surgery, 2nd ed. New York: Churchill Livingstone Inc., 1993: 1220.
DeLeon SY, Ilbawi MN, Arcilla RA, Thilenius OG, Quinones JA, Duffy EC, et al. Transatrial relief of diffuse subaortic stenosis after ventricular septal defect closure. Ann Thorac Surg 1990; 49: 429–34.
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Atsumi, N., Enomoto, Y., Gomi, S. et al. Extended septoplasty for subaortic stenosis developed 19 years after double-outlet right ventricle repair. Jpn J Thorac Caridovasc Surg 48, 362–365 (2000). https://doi.org/10.1007/BF03218156
- subaortic stenosis
- extended septoplasty