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Small aortic valve annulus in children with fixed subaortic stenosis.
O G Thilenius1, D Campbell, S Bharati
1Heart Institute for Children, Oak Lawn, Illinois.
Pediatric Cardiology
|January 1, 1989
Summary
Fixed subaortic stenosis (FSAS) in children often involves abnormal aortic valve leaflets and a small annulus. Some patients require a Konno operation due to the small aortic annulus, as simple resection is insufficient.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Fixed subaortic stenosis (FSAS) is a congenital heart defect characterized by a ridge of tissue below the aortic valve.
- Understanding the anatomical features of FSAS is crucial for effective surgical management.
Purpose of the Study:
- To pathologically examine hearts with FSAS.
- To compare echocardiographic and angiocardiographic findings in children with FSAS, valvar aortic stenosis, and healthy controls.
- To determine the optimal surgical approach for FSAS based on anatomical findings.
Main Methods:
- Pathological examination of 21 hearts with FSAS.
- Echocardiography and angiocardiography in 30 healthy children, 31 with valvar aortic stenosis, and 25 with FSAS.
- Analysis of aortic valve annulus size and aortic valve leaflets.
Main Results:
- Patients with FSAS frequently exhibit abnormal aortic valve leaflets and a small aortic valve annulus.
- A small aortic annulus to descending aorta ratio may be congenital and decrease with age.
- M-mode echocardiography was not effective in identifying small aortic valve annuli in FSAS patients.
Conclusions:
- FSAS management requires careful assessment of aortic valve annulus size.
- A small annulus may necessitate a Konno operation, rather than simple resection.
- Early identification of anatomical abnormalities is key for successful surgical outcomes in FSAS.