Surgery for discrete subaortic stenosis yielded good results for type I but unsatisfactory results for type II, with postoperative aortic incompetence likely to develop in both types.
Observational (n=25)
Does surgical intervention yield different outcomes based on the morphological type of discrete subaortic stenosis?
Discrete subaortic stenosis can be divided into two morphological types with distinct surgical prognoses, though both carry a risk of postoperative aortic incompetence.
Twenty-five patients with discrete subaortic stenosis were reviewed. Twenty were operated on for severe obstruction. Review of available data suggests there is a wide spectrum of the disease which may be divided into two main types designated I and II. Type I is a thin discrete membrane immediately under the aortic valve obstructing the outflow but not associated with narrowing of it. Type II is situated about 1 cm below the valve and consists of a fibrous ring, thicker than type I, and associated with muscular hypertrophy which narrows the outflow tract, encroaches on the anterior leaflet of the mitral valve, and may extend 1-2 cm downward. Both have a characteristic angiographic appearance. Results of surgery are good for type I but not satisfactory for type II. Aortic incompetence is likely to increase or develop following operation in both types.
Kelly et al. (Tue,) conducted a observational in Discrete subaortic stenosis (n=25). Surgery was evaluated on Surgical outcomes and development of aortic incompetence. Surgery for discrete subaortic stenosis yielded good results for type I but unsatisfactory results for type II, with postoperative aortic incompetence likely to develop in both types.
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