1/15. Discrete subvalvular aortic stenosis in adults.Discrete subvalvular aortic stenosis is a relatively rare condition in adults. It is often diagnosed during first decade of life especially in association with other congenital malformations. Isolated form of discrete subvalvular aortic stenosis may however silently progress from innocent murmurs of childhood and adolescence to symptomatic left ventricular outflow tract obstruction in adults. Certain overt and subtle morphological abnormalities may underlie the initial expression as well as high recurrence rates after surgical resection of sub aortic membrane. Though surgical resection is the only treatment available, debate on the surgical technique and appropriate timing of surgery continues. Close followup with serial echocardiographic examinations in patients detected to have functional murmurs during childhood may be helpful in early detection of subvalvular aortic stertosis.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/15. Accessory mitral valve tissue in combination with subaortic membrane and significant impairment of left ventricular function.A 6-year-old girl was found to have a combination of accessory mitral valve tissue and subaortic membrane. The association caused left ventricular outflow tract obstruction leading to severe left ventricular dysfunction. Surgical relief of the obstruction resulted in immediate improvement of ventricular function.- - - - - - - - - - ranking = 5keywords = membrane (Clic here for more details about this article) |
3/15. Intraoperative transesophageal echocardiographic demonstration of mitral leaflet tear following resection of a subaortic membrane.A patient developed a tear of the anterior mitral leaflet following surgical resection of a stenotic subaortic membrane. This complication was diagnosed by intraoperative transesophageal echocardiography leading to successful repair of the mitral leaflet tear.- - - - - - - - - - ranking = 5keywords = membrane (Clic here for more details about this article) |
4/15. Subaortic stenosis: recurrence of a fibrous ring after 28 years.Aortic stenosis is a common cardiac problem. Morphological aortic stenosis can be due to valvular, subvalvular and supravalvular causes. Subvalvular causes include subaortic rings and membranes, which usually manifest at a young age, depending on the size of the ring and the degree of obstruction. Recurrent (post-operative) stenosis is a rare potential problem. A case of recurrent subaortic stenosis due to a subaortic ring, 28 years after the initial surgical excision of the ring is presented.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
5/15. Subaortic membrane in an adult patient with coronary artery disease.A case of subaortic membrane with coronary artery disease in a 48-year-old man is described. He was referred to our hospital for cardiac murmur, which was discovered on routine clinical examination. He had no significant past medical history apart from dizziness while exercising. Subaortic membrane was totally excised; left internal thoracic artery was anastomosed to left anterior descending artery by end-to-side technique. The postoperative 2-year course of the patient was uneventful.- - - - - - - - - - ranking = 6keywords = membrane (Clic here for more details about this article) |
6/15. Cardiac arrest under anesthesia in a pediatric patient with williams syndrome: a case report.Serial cardiac arrests occurred during the induction of a 3-year-old boy for elective 1-sided orchiopexy surgery and evaluation under anesthesia of previously placed ear tympanoplasty tubes. The child's history included williams syndrome along with hypercalcemia and mild supravalvular aortic stenosis. The initial arrests included significant ST wave changes along with profound brodycardia, hypotension, and pulseless electrical activity requiring full resuscitation twice. The patient was transferred on an emergency basis to the intensive care unit (the surgery was cancelled), and a heart catheterization was scheduled for the following morning. The patient experienced several cardiac arrests during the cardiac catheterization procedure, necessitating emergency extracorporeal membrane oxygenation cannulation and immediate transfer to the operating room for emergency cardiac surgery. A thorough preoperative cardiac workup, including cardiac catheterization, electrocardiogram, and echocardiogram, may decrease mortality and morbidity in patients with williams syndrome. However, cardiac catheterization has been associated with increased risk in this patient population.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
7/15. Subvalvular aortic stenosis as a cause of sudden death: two case reports.Sudden death is defined as a death that occurs suddenly, develops during an unpredictable course, and is due to natural or unnatural causes. Although there is no universally standardized definition on how "sudden" a sudden death is, WHO defines sudden death as a death that occurs within 24 hours after the onset of symptoms. The aim of this study is to present 2 rarely reported autopsy cases and to emphasize the importance of systemic autopsy at sudden death. On macroscopic examination, crescent-shaped, thick, fibrous membranes, located 5 mm and 3 mm away from the aortic valves, were detected. Fibrous membranes extended from the ventricular septum to the left ventricular outflow tract, thus apparently narrowing this region. Left ventricular wall and septum were slightly thickened, and there were scattered grayish-white areas of a small diameter. These became more intense in the septum and myocardium of the left ventricle on the anterior plane of the myocardial sections. In both cases, the aortic valves of were thickened and also markedly narrowed on one of them. In this case, the fibrous membrane adhered to the aortic valve and extended to the anterior leaflet of the mitral valve at one side. Both aortic valves comprised 3 leaflets. Other valves and coronary arteries showed no macroscopic pathologic findings. Microscopic examination of both cases demonstrated that the fibrous membrane comprising abundant collagen fibers was situated on the ventricular septum. hypertrophy, moderate to severe interstitial fibrosis, and focal areas of scarring were observed in the specimens taken from the septal and ventricular myocardium. No abnormality was found on the conduction system examinations. Toxicologic analysis results in blood were negative. Based on the findings, membranous-type (discrete type) subvalvular aortic stenosis, diagnosed during the autopsy, was considered as the cause of sudden death in both cases.- - - - - - - - - - ranking = 4keywords = membrane (Clic here for more details about this article) |
8/15. Obstruction of the left ventricular outflow tract by the mitral valve due to a muscle band.This paper details a rare cause of subaortic obstruction--a muscle band tethering the anterior leaflet of the mitral valve to the ventricular septum. Excision of this band released the leaflet and cured the obstruction. The patient also had a discrete subaortic membranous obstruction, the membrane being excised.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
9/15. Familial occurrence of discrete subaortic membrane.The first case of multiple family members with discrete subaortic membrane and no other congenital defects is presented. One family member presents with findings suggesting a forme fruste of this disease. Increased surveillance of family members of individuals with discrete subaortic membrane is warranted, as the clinical findings of mild subaortic obstruction may be indistinguishable from those of an innocent flow murmur.- - - - - - - - - - ranking = 6keywords = membrane (Clic here for more details about this article) |
10/15. Echocardiographic features of combined hypertrophic and membranous subvalvular aortic stenosis: a case report.Combined hypertrophic and membranous subvalvular aortic stenosis was detected by echocardiography. The diagnosis was established by the discovery of severe asymmetric septal hypertrophy, a membrane in the left ventricular outflow tract, narrowing of the left ventricular outflow tract, as well as high frequency fluttering and premature systolic closure of the aortic valve leaflets.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
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