This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Katz, N. M. Articles by Liberthson, R. R. Search for Related Content PubMed PubMed Citation Articles by Katz, N. M. Articles by Liberthson, R. R.

Circulation, Vol 56, 1034-1038, Copyright © 1977 by American Heart Association

ARTICLES

Discrete membranous subaortic stenosis. Report of 31 patients, review of the literature, and delineation of management

NM Katz, MJ Buckley and RR Liberthson

The presentation, management, and follow-up of 31 patients with discrete membranous subaortic stenosis (DMSS) is presented. DMSS comprised 16% of 185 patients with congenital left ventricular (LV) obstruction. Only one patient was older than 40 years. The rarity of DMSS in older patients in both our population and in the literature is noted, and possible explanations are discussed. One-quarter of these patients had dyspnea, chest pain, or syncope combined with electrocardiographic left ventricular hypertrophy (LVH) and strain, and these all had peak LV outflow gradients (PSG) greater than 85 mm Hg. One-quarter had neither symptoms nor electrocardiographic abnormalities and all had PSG less than 90 mm Hg. Bacterial endocarditis was found in 13%, and in 13% an immediate family member also had congenital LV obstruction. Following surgical resection (25 patients), 18 were asymptomatic, two had residual fibromuscular obstruction, and four developed new fibromuscular obstruction after from one to six years (leading in one to late sudden death). Thus, even after resection, these patients require continued re-evaluation for residual or new LV obstruction.

This article has been cited by other articles:

				A. Geva, C. J. McMahon, K. Gauvreau, L. Mohammed, P. J. del Nido, and T. Geva Risk Factors for Reoperation After Repair of Discrete Subaortic Stenosis in Children J. Am. Coll. Cardiol., October 9, 2007; 50(15): 1498 - 1504. [Abstract] [Full Text] [PDF]

				J. Aboulhosn and J. S. Child Left Ventricular Outflow Obstruction: Subaortic Stenosis, Bicuspid Aortic Valve, Supravalvar Aortic Stenosis, and Coarctation of the Aorta Circulation, November 28, 2006; 114(22): 2412 - 2422. [Full Text] [PDF]

				H. Polito Accessory Mitral Valve Tissue Causing Mitral Valve Obstruction and Left Ventricular Outflow Tract Obstruction in a Young Adult Journal of Diagnostic Medical Sonography, January 1, 2005; 21(1): 56 - 61. [Abstract] [PDF]

				A M Cilliers and M Gewillig Rheology of discrete subaortic stenosis Heart, October 1, 2002; 88(4): 335 - 336. [Abstract] [Full Text] [PDF]

				J. M. Oliver, A. Gonzalez, P. Gallego, A. Sanchez-Recalde, F. Benito, and J. M. Mesa Discrete subaortic stenosis in adults: increased prevalence and slow rate of progression of the obstruction and aortic regurgitation J. Am. Coll. Cardiol., September 1, 2001; 38(3): 835 - 842. [Abstract] [Full Text] [PDF]

				K. Niwa, J. K. Perloff, S. M. Bhuta, H. Laks, D. C. Drinkwater, J. S. Child, and P. D. Miner Structural Abnormalities of Great Arterial Walls in Congenital Heart Disease : Light and Electron Microscopic Analyses Circulation, January 23, 2001; 103(3): 393 - 400. [Abstract] [Full Text] [PDF]

				S. Atalay, S. Turkay, H. Gumus, A. Imamoglu, and H. Ercan Tutar Echocardiographic, Morphologic, and Geometric Variations of the Left Ventricular Outflow Tract: Possible Role in the Pathogenesis of Discrete Subaortic Stenosis Angiology, March 1, 2000; 51(3): 213 - 221. [Abstract] [PDF]

				C V Rohlicek, S F. del Pino, M Hosking, J Miro, J-M Côté, and J Finley Natural history and surgical outcomes for isolated discrete subaortic stenosis in children Heart, December 1, 1999; 82(6): 708 - 713. [Abstract] [Full Text]

				T. D. Lampros and A. Cobanoglu Discrete subaortic stenosis: an acquired heart disease Eur. J. Cardiothorac. Surg., September 1, 1999; 14(3): 296 - 303. [Abstract] [Full Text] [PDF]

				S. T. Rayburn, D. E. Netherland, and B. J. Heath Discrete Membranous Subaortic Stenosis: Improved Results After Resection and Myectomy Ann. Thorac. Surg., July 1, 1997; 64(1): 105 - 109. [Abstract] [Full Text]

				G. M. Folger The Spectrum of Left Ventricular Outflow Tract Obstruction: an Overview Angiology, November 1, 1980; 31(11): 779 - 799. [PDF]