Key result
Surgical resection of sub-aortic membrane significantly reduced the mean left ventricular outflow tract gradient from 94.7 mmHg pre-operatively to 20.7 mmHg post-operatively.
Why the study?
Does surgical resection of sub-aortic membrane improve LVOT gradients in patients with sub-aortic stenosis?
Observational (n=51)
No
Does surgical resection of sub-aortic membrane improve LVOT gradients in patients with sub-aortic stenosis?
Absolute Event Rate: 20.7% vs 94.7%
p-value: p=<0.001
Early surgical resection of sub-aortic membrane safely and significantly reduces LVOT pressure gradients with good early outcomes.
Resection of subaortic membrane was associated with marked LVOT gradient reduction and minimal AR progression; supports surgical efficacy in observational data but leaves open randomized confirmation.
Objectives: In this study, we presented our results regarding outcomes ofsurgical correction of sub-aortic membrane. Study Design: Retrospective observational study.Period: June 2012 to June 2017. Setting: CPEIC Multan, Pakistan. Methods: 51 patientsoperated for resection of sub aortic membrane. The resection of sub aortic membrane wasdone through the aorta. Evaluation of the aortic valve done in all patients. The aortic valve waseither replaced or repaired in cases of severe aortic regurgitation. Associated lesions such asventricular septal defects (VSD’s) were repaired with a dacron patch through the right atriumwhile ASD’s were repaired with a pericardial patch. Post-operative echocardiography was donebefore discharge and post-op LVOT gradients and aortic insufficiency were recorded for allthe patients. Results: There were 36 males and 15 females whose mean ages were 16.29years. On post-op echocardiography there was no residual significant LVOT gradient in anypatient. Three (3) patients developed mild to moderate aortic regurgitation post operativelybut none of them warrant any surgical intervention. There was only 1 death in the series whichwas due to VSD patch dehiscence. None of the patients developed conduction problems postoperatively needing any permanent pace maker. Mean pre-op LVOT gradient was 94.7 mmHgwhile it reduced to 20.7 post operatively (p-value <0.001). Conclusion: We concluded thatearly resection of sub aortic membrane can be safely accomplished with good results andsignificant drop in the mean LVOT pressure gradients post operatively.
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Waqar et al. (2017) conducted an observational in Sub-aortic membrane (n=51). Surgical resection of sub-aortic membrane vs. Pre-operative baseline was evaluated on Mean LVOT gradient (mmHg) (p=<0.001). Surgical resection of sub-aortic membrane significantly reduced the mean left ventricular outflow tract gradient from 94.7 mmHg pre-operatively to 20.7 mmHg post-operatively.
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