This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Wu, W.-S. Articles by Yang, Y.-J. Search for Related Content PubMed PubMed Citation Articles by Wu, W.-S. Articles by Yang, Y.-J.

(Circulation. 1998;97:605-606.)
© 1998 American Heart Association, Inc.

Images in Cardiovascular Medicine

Unusual Manifestation of Subaortic Membrane

Wen-Shiann Wu, MD; Jeng-Kai Teng, MD, PhD; Liang-Miin Tsai, MD; Wei-Chuan Tsai, MD; Lin-Jen Lin, MD; Yi-Heng Li, MD; Jyh-Hong Chen, MD, PhD; ; Yu-Jen Yang, MD

From the Division of Cardiology, Cardiac Surgery (Y.-J.Y.), National Cheng Kung University Medical College and Hospital, and Chi-Mei Foundation Hospital (W.-S.W.), Tainan, Taiwan.

A 52-year-old man complained of dyspnea on exertion for 1 month. On auscultation, a grade 3/6 to-and-fro murmur was heard at the left lower sternal border and was well transmitted to the apex. Fig 1 is the transesophageal echocardiographic image of this patient at that time. Figs 2 and 3 were produced by cardiac catheterization. There was no significant pressure gradient among aorta, subaortic chamber, and left ventricle.

View larger version (100K): [in this window] [in a new window]   Figure 1. Transesophageal echocardiography demonstrated a calcified aortic valve and a serpentine, elongated subaortic membrane adhering to right coronary cusp and interventricular septum. AO indicates aorta; LA, left atrium; LV, left ventricle; NCC, noncoronary cusp; RCC, right coronary cusp; arrows, subaortic membrane; SA, subaortic membrane; SA, subaortic chamber; and RV, right ventricle.

View larger version (164K): [in this window] [in a new window]   Figure 2. Aortogram with right anterior oblique projection showed an eccentric regurgitant jet (arrow) from aorta toward left ventricle, and an abnormal subaortic chamber (SA) was also simultaneously visualized. Two arrowheads outline subaortic membrane.

View larger version (152K): [in this window] [in a new window]   Figure 3. Atypical subaortic membrane with chamber (SA) was demonstrated in left anterior oblique projection with cranial beam angulation. Side hole of catheter was placed at subaortic chamber, and contrast medium was injected. Jet (white arrow) formed by regurgitation of contrast medium through narrow orifice in membrane into left ventricle was found. Another jet (black arrow) was aortic regurgitation.

The patient underwent open-heart surgery several days later.Surgery revealed a 1x2-cm defect at the right coronary sinus of Valsalva and a huge subaortic membrane (10x20 cm) adhering to the right coronary cusp and interventricular septum (Fig 4. . . [Full Text of this Article]

This article has been cited by other articles:

				R. L. Berger and I. Kronzon The vanishing subaortic membrane Eur J Echocardiogr, July 1, 2008; 9(4): 569 - 571. [Abstract] [Full Text] [PDF]