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[Discrete subaortic stenosis after aortic valve replacement--a case report]

K Iha¹, K Koja, Y Kuniyoshi

¹Second Department of Surgery, Faculty of Medicine, University of Ryukyus, Okinawa, Japan.

[Zasshi] [Journal]. Nihon Kyobu Geka Gakkai

|July 1, 1994

Summary

A discrete subaortic ring was found below a prosthetic aortic valve in a patient requiring redo surgery. Resection of the ring and valve replacement resolved the stenosis.

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Area of Science:

Cardiovascular Surgery
Cardiac Valve Disease
Medical Device Technology

Background:

A 51-year-old woman presented for redo surgery due to complications following initial aortic valve replacement and mitral commissurotomy.
The patient had pre-existing conditions of aortic valve stenosis with regurgitation and mitral stenosis.

Observation:

During redo surgery, a discrete subaortic ring was identified directly beneath the existing prosthetic aortic valve.
This fibrous ring was causing significant obstruction.

Findings:

The subaortic ring was successfully resected.
The aortic valve was replaced with a larger prosthesis (SJM 21 mm) after aortic annulus augmentation using the Nicks procedure.
Additional valve replacements were performed for the mitral and tricuspid valves.

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Implications:

Discrete subaortic stenosis post-aortic valve replacement is often associated with small prosthetic valves.
Turbulence from undersized prosthetic valves may contribute to the formation of subaortic rings.
This case highlights the importance of appropriate valve sizing and potential complications like subaortic stenosis.