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A retrospective review in 50 patients with subaortic stenosis and intact ventricular septum: 5-year surgical experience

^a Department of Paediatrics, Cardiac Morphology Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK
^b Department of Cardiothoracic Surgery, Royal Brompton Hospital, London, UK
^c National Heart & Lung Institute, Imperial College, London, UK

*Corresponding author. Tel.: +44 207 351 8751; fax: +44 207 351 8230.

E-mail address: r.barkhordarian{at}imperial.ac.uk (R. Barkhordarian).

We reviewed the surgical outcomes in adults and children with subaortic stenosis and intact ventricular septum in the current era. The case notes of 50 patients were reviewed for retrospective evaluation of preoperative, intraoperative and postoperative data. Data of primary operations during the period 2000–2005 were compared with data from patients who had re-do surgery during the same period. Thirty-five patients had primary operation and 15 patients had re-do surgery. The median age at primary operation was eight years (range 3 to 44), at second operation was 14 years (range 9 to 26) and at third operation was 15 (range 9 to 47). The entire group had been followed up postoperatively for a median of 2.5 years (range 0 to 5). Pre-operatively, aortic regurgitation was moderate in 13 and severe in three patients. Moderate to severe aortic regurgitation was present in 7 (20%) patients with primary operations and 9 (60%) patients with re-do surgery (P=0.01). Reviewing the first operations of all the re-dos (15 patients) in our series, one patient had myectomy and the rest (14 patients) had isolated resection. Aortic valve regurgitation is more prevalent in patients with recurrent subaortic stenosis. Addition of myectomy is better than shelf resection only.

Key Words: Congenital heart disease; Aortic stenosis

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