[Surgical experience with a case of subaortic stenosis previously treated by patch closure of ventricular septal...

A patient who developed subaortic stenosis ten years after patch closure of perimembranous VSD was surgically treated. The subaortic obstruction could not relief sufficiently by the conventional transaortic maneuver. In this surgery, additional ventriculo-septoplasty (modified Konno's operation or Cooley's operation) was performed, preserving the patient's own aortic valve, because of the valve and the valvular ring diameter were almost normal. The postoperative course was uneventful. In this case, a posterior deviation of the infundibular septum and the ventricular septal patch seemed to have played an important role in the pathogenesis of the development of subaortic stenosis.