1/4. Proximal isovelocity surface area (PISA) in the evaluation of fixed membranous subaortic stenosis.The evaluation of the severity of subaortic stenosis is usually expressed by the magnitude of the subvalvular gradient. Calculation of the membrane orifice area noninvasively is difficult by the standard means. We present a patient in whom the area was calculated using the proximal isovelocity surface area (PISA) method. This method should have clinical applicability because it is not flow dependent and can be used in patients with normal, reduced, or increased stroke volume.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |
2/4. Live three-dimensional transthoracic echocardiographic identification of discrete subaortic membranous stenosis.We describe an adult patient in whom live three-dimensional transthoracic echocardiography illustrated the exact site and full extent of the subaortic membrane as well as the narrow opening within the membrane, indicative of severe stenosis. To our knowledge this has not been reported previously.- - - - - - - - - - ranking = 2keywords = membrane (Clic here for more details about this article) |
3/4. Cystic subaortic discrete membrane in an elderly woman.A discrete subaortic membrane is an uncommon cause of left ventricular outflow tract (LVOT) obstruction in patients of advanced age. Here, a significant LVOT obstruction caused by a discrete membrane is reported in a 64-year-old woman. On echocardiographic examination the membrane had a cystic appearance. To the present authors' knowledge, this is the first reported case of a cystic subaortic membrane.- - - - - - - - - - ranking = 8keywords = membrane (Clic here for more details about this article) |
4/4. Recurrent discrete subaortic stenosis and small aortic annulus successfully repaired by the Konno procedure in a young woman.A 24-year-old woman who had undergone excision of the membrane for discrete subaortic stenosis when 6 years old displayed recurrent subaortic stenosis and had a small aortic annulus, with a peak pressure gradient of 60mmHg. We chose to perform the Konno operation with a mechanical valve. This released the left ventricular outflow tract obstruction adequately, and she recovered uneventfully with new york heart association functional class I. In our experience, an aggressive strategy such as myectomy is an appropriate initial procedure for preventing recurrence when the geometry of the problem may lead to recurrence in the left ventricular outflow tract. The Konno operation is a good option for recurrent subaortic stenosis with small aortic annulus.- - - - - - - - - - ranking = 1keywords = membrane (Clic here for more details about this article) |