Fixed Subaortic Stenosis In Infants and Children

Abstract

Fixed subaortic stenosis(FSS) is important because of not only obstruction but also aortic insufficiency. This study was performed to find out the characteristics and combined anomalies of FSS. Echocardiographic and clinical data were reviewed in 31 children who were diagnosed as FSS between March 1985 and February 1991 (age: 2months-12yr7months, M:F = 2:1). Cardiac defects were associated in 26(84%) and the majority of the cases were related to VSD(VSD only: 14 cases, VSD with other anomalies: 7 cases). The type of VSD was perimembranous in 86%(18/21) and subarterial in 14%(3/21). Aortic insufficiency(AO was present in 13 cases(42%) and the degree of AI was usually mild. The mean pressure gradient between the left ventricle and the aorta was 21mmHg by cardiac catheterization in 27. Operative resection was done in 20; 11 during the correction of major defects, 4 for AI, 5 for significant pressure gradient. The pathologic findings of 13 were mainly fibrosis and hypertrophied myocardium. In conclusion, because of the possible association with other cardiac defects, especially perimembranous VSD and its co~rt features, it is recommended to pay attention to the coexistence of FSS during the evaluation of cardiac defects.