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"Acquired" subvalvular aortic stenosis after repair of a ventricular septal defect
M P Cicini1, S Giannico, B Marino
1Department of Pediatric Cardiology and Cardiac Surgery, Bambino Gesú Hospital, Rome, Italy.
Insights
Postsurgical subaortic stenosis is an uncommon, progressive acquired condition. It developed in 12 children after congenital heart defect repair, with some requiring further intervention.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease Surgery
- Acquired Cardiovascular Conditions
Background:
- Congenital heart defects (CHDs) are common in children.
- Surgical repair is the standard treatment for many CHDs.
- Subaortic stenosis is a narrowing below the aortic valve.
Purpose of the Study:
- To investigate the incidence and characteristics of subaortic stenosis developing after surgical repair of congenital heart defects.
- To describe the clinical course and management of postsurgical subaortic stenosis.
Main Methods:
- Retrospective review of 353 children undergoing surgical repair for congenital heart defects.
- Analysis of patients who developed subaortic stenosis post-surgery.
- Review of diagnostic methods and treatment outcomes.
Main Results:
- 12 out of 353 children (3.4%) developed subaortic stenosis 1-6 years after surgery.
- Affected patients had various CHDs including VSD, Tetralogy of Fallot, and double-outlet right ventricle.
- Five patients needed re-operation, and one underwent balloon angioplasty.
Conclusions:
- Postsurgical subaortic stenosis is an uncommon, progressive, acquired complication following CHD repair.
- Early diagnosis and intervention may be necessary for affected patients.
- Further research is needed to understand the pathogenesis and long-term implications.
Abstract:
Of 353 children who underwent surgical repair of a congenital heart defect, including closure of a ventricular septal defect (VSD), 12 patients (four with tetralogy of Fallot, five with a VSD, and three with a double-outlet right ventricle) developed subaortic stenosis, which was diagnosed one to six years after the surgical procedure. Five patients required surgical treatment of the subaortic stenosis, and one required percutaneous balloon angioplasty. Postsurgical subaortic stenosis appears to be an uncommon progressive acquired disease.