Pregnant woman with severe subaortic stenosis successfully treated with open-heart surgery resection: A case report

Subaortic stenosis (SubAS) is a type of left ventricular outflow obstruction. Pregnancy is a hemodynamically stressful event that can undercover a previous undiagnosed severe SubAS. In this article, we present a case of pregnant woman with SubAS successfully treated with heart surgery.

A 34-year-old primigravida at gestational week 19, was admitted to the emergency department with a highly symptomatic severe SubAS refractory to medical treatment. Obstetric evaluation showed normal fetal development. The patient was treated with heart surgery to resect the subaortic membrane. She recovered satisfactorily after surgery and held the gestation until 39 weeks giving birth to a healthy baby.

Heart diseases are the main cause of non-obstetric deaths in pregnant women. Patients with SubAS typically develop symptoms after the first decade of life as the disease progresses over time. Pregnancy can act as a trigger for the development of symptoms, sometimes requiring urgent treatment. Surgical treatment in pregnant woman is a high-risk condition for the fetus and should be reserved to the refractory cases.

SubAS in pregnancy may be successfully managed through open heart surgery. Careful consideration of maternal and fetal risks, together with multidisciplinary collaboration, is essential in guiding management decisions.