J Cardiovasc Ultrasound.  2010 Jun;18(2):52-54. 10.4250/jcu.2010.18.2.52.

Secondary Subaortic Stenosis after Patch Closure of Subarterial Ventricular Septal Defect

• Cho YK
• Oh SM
• Joo JW
• Ma JS

• KMID: 2135438
• DOI: http://doi.org/10.4250/jcu.2010.18.2.52

Abstract

Subaortic stenosis usually occurs without a previous heart operation, however, it can occur after heart surgery as well, with a condition known as a secondary subaortic stenosis (SSS). SSS has been reported after surgical repair of several congenital heart defects. There are only a few recorded cases of SSS after repair of ventricular septal defect (VSD). Here we report a rare case of SSS that occurred 3 years after surgical repair of subarterial VSD. A follow-up echocardiogram is essential for detecting SSS caused by the newly developed subaortic membrane in patients who had cardiac surgery.

Keyword

Echocardiography; Discrete subaortic stenosis; Ventricular septal defect

MeSH Terms

Constriction, Pathologic
Discrete Subaortic Stenosis
Echocardiography
Heart
Heart Defects, Congenital
Heart Septal Defects, Ventricular
Humans
Membranes
Thoracic Surgery

Figure

• 

  Fig. 1 Color Doppler imaging from parasternal long axis view (A) and parasternal short axis view (B) shows a large subarterial ventricular septal defect (arrows) at initial diagnosis. RV: right ventricle, LV: left ventricle, LA: left atrium, Ao: aorta, PA: pulmonary artery.

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  Fig. 2 After patch closure of the subartrial ventricular septal defect, echocardiography shows no discrete subaortic membrane (arrow) (A) and no blood flow disturbance in the left ventricular outflow tract (B). RV: right ventricle, LV: left ventricle, LA: left atrium, Ao: aorta.

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  Fig. 3 Two dimensional echocardiography in the systolic phase shows subaortic stenosis (A) due to discrete subaortic membrane (arrow) and turbulent blood flow in the subaortic region during the systolic phase (B). RV: right ventricle, LV: left ventricle, LA: left atrium, Ao: aorta.

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  Fig. 4 Peak pressure gradient is estimated at 24 mmHg by Doppler echocardiography (A), and M-mode echocardiography shows a mid-systole partial closure of the aortic valve (arrow) (B). RV: right ventricle, LV: left ventricle, LA: left atrium, Ao: aorta.

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