Key result
Surgical membrane resection and mechanical valve replacement improve hemodynamics in dual-level LVOT obstruction.
Why the study?
Discrete subaortic membranes are an uncommon cause of left ventricular outflow tract obstruction in adults and may coexist with aortic valve disease.
Case Report (n=1)
May inform surgical decisions in rare dual-level LVOT obstruction; leaves open need for prospective validation in heart failure.
BACKGROUND: Discrete subaortic membranes are an uncommon cause of left ventricular outflow tract (LVOT) obstruction in adults and may coexist with aortic valve disease. CASE SUMMARY: A 50-year-old man presented with acute decompensated heart failure. Transthoracic echocardiography showed reduced ejection fraction (30%-35%) and demonstrated severe calcific aortic stenosis with regurgitation. Transesophageal echocardiography revealed a discrete subaortic membrane causing additional subvalvular obstruction, consistent with dual-level LVOT obstruction. Invasive hemodynamics confirmed advanced afterload-mediated heart failure. The patient underwent surgical membrane resection and mechanical valve replacement with subsequent clinical and hemodynamic improvement. DISCUSSION: Coexisting subvalvular and valvular obstruction is uncommon in adults and may present diagnostic challenges. Multimodality imaging is essential to differentiate obstruction levels and guide surgical management. TAKE-HOME MESSAGE: Comprehensive multimodality imaging is essential to identify dual-level LVOT obstruction and ensure correction of both valvular and subvalvular disease.
No takes yet. Share an insight, caveat, or question.
Roufeh et al. (2026) conducted a case report in Dual-level left ventricular outflow tract obstruction and acute decompensated heart failure (n=1). Surgical membrane resection and mechanical valve replacement was evaluated on Clinical and hemodynamic improvement. Surgical membrane resection and mechanical valve replacement resulted in clinical and hemodynamic improvement in a patient with dual-level left ventricular outflow tract obstruction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: