Subvalvular aortic stenosis: a review of current literature

Abstract

Subvalvular aortic stenosis (SAS) is one of the common adult congenital heart diseases, with a prevalence of 6.5%. It is usually diagnosed in the first decade of life. Echocardiography is the test of choice to diagnose SAS. Surgical correction is the best treatment modality, and the prognosis is usually excellent. In this review, we describe the pathophysiology, diagnosis, prognosis, and management of SAS with a focus on different pathophysiologic mechanisms, diagnostic approach, and prognosis of the disease by reviewing the current literature.

Echocardiographic Diagnosis of a Subaortic Membrane Attached to the Free Edge of the Right Coronary Cusp of the Aortic Valve

“…8 Patients with tunnel-type membranes and those with LVOTobstruction at multiple levels tend to have a worse prognosis in terms of risk for recurrence and reoperation. 6 In this case, TTE demonstrated a seemingly classic appearance of a fibromuscular ridge. However, TEE has superior resolution and clearly showed a highly unusual attachment to the free edge of the right coronary cusp.…”

“…Echocardiography is the test of choice for diagnosis. 6 Furthermore, it can be used to characterize the anatomy of the membrane, determine the severity of obstruction, and evaluate the integrity of the mitral and aortic valves. If additional information is needed, cardiac magnetic resonance imaging, computed tomography, and cine angiography may also play a role.…”

“…TEE may provide a more reliable and accurate diagnosis compared with TTE and is especially valuable when the findings on TTE are inconclusive. 6 Had TEE been performed earlier, this unusual variant would likely not have been an intraoperative surprise, possibly allowing additional time for better surgical planning. Interestingly, close inspection of the transthoracic echocardiographic parasternal long axis (Video 1) does raise suspicion for attachment to the aortic valve.…”

Membranous subaortic stenosis coexisting with hypertrophic cardiomyopathy: A case report

“…Subaortic stenosis (SAS), a congenital heart disease, is associated with the obstruction of the left ventricular outflow tract (LVOT) and is divided into two types, discrete membranous SAS and diffuse fibromuscular SAS . SAS coexisting with hypertrophic cardiomyopathy is very rare and also clinically underappreciated .…”

“…Subaortic stenosis (SAS), a congenital heart disease, is associated with the obstruction of the left ventricular outflow tract (LVOT) and is divided into two types, discrete membranous SAS and diffuse fibromuscular SAS. 1 SAS coexisting with hypertrophic cardiomyopathy is very rare and also clinically underappreciated. 2 Echocardiography is the primary tool for the diagnosis of SAS, but it still may be difficult to distinguish SAS from hypertrophic cardiomyopathy with obstruction (HOCM) due to the fact that some of SAS cases share similar clinical manifestations such as asymmetric septal hypertrophy with cases of HOCM.…”