Surgical Management Of Discrete Subaortic Stenosis

Objective To review retrospectively the clinical experience in treatment of discrete subaortic stenosis(DSAS). Methods From November 1992 to November 2005,20 cases of DSAS were enrolled,including 18 membranous and 2 fibrousmuscular stenosis. Simply resection of stenosis membrane or ridge was performed in 16 cases and plus myoctomy in 2 cases. Associated cardiac anomalies were corrected at the same time in 14 cases, in which there were 12 cases with ventricular septal defect (2 cases with double chamber right ventricles at the same time) and 2 cases with patent ductus arteriosus.2 cases were not carried surgical management. Results There was no operative mortality, disappearance of cardiac murmur was found in 15 cases and diminishment of cardiac murmur in 3 cases. After 3 months to 2 years follow-up, the cardiac ultrasound suggested that the left ventricular outflow tract was fluent without recurrent constriction. Conclusion DSAS is a progressive disease, Better knowledge of pathological anatomy, timing of surgery, the key to the operation is that left ventricular outflow tract should be thoroughly dredged,no injury should be made to the aortic valve, mitral valve and conduction bundle.