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  • Title: Discrete subaortic stenosis: an acquired heart disease.
    Author: Lampros TD, Cobanoglu A.
    Journal: Eur J Cardiothorac Surg; 1998 Sep; 14(3):296-303. PubMed ID: 9761441.
    Abstract:
    OBJECTIVE: To determine the anatomic variables in the left ventricular outflow tract in patients with subaortic stenosis. METHODS: Between 1982 and 1996, 36 patients were operated on with the 'discrete' form of subaortic stenosis (DSS). The mean time of follow up was 7.4 years with a range of 4 months-14 years. There were 25 male and 11 female patients. Mean age at operation was 7.1 years with a range of 9 months-47 years. RESULTS: At the time of surgery, the mitral valve apparatus and interventricular septum were found to be rotated 60-90 degrees in a counterclockwise fashion with anterior displacement into the left ventricular outflow tract in 30 (83%) patients. Subaortic ridge resection with a deep septal myectomy was performed in 32 patients and the remaining four patients had subaortic ridge resection alone. The reoperation free rate at 5 and 10 years were 74+/-9% and 60+/-12%, respectively. Reoperations for recurrent disease were performed in 10 (27.7%) patients. No operative or late follow up deaths were encountered. CONCLUSION: We conclude that DSS is an acquired disease due to a pre-existing anatomic alteration in the mitral valve apparatus and interventricular septum. In addition, recurrence rates are high and physicians should not be mislead by the benign nomenclature its name implies.
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