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11/82. 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.
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ranking = 1
keywords = subaortic
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12/82. 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.
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ranking = 1.7223429562224
keywords = subvalvular, subaortic, stenosis
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13/82. chordae tendineae rupture resulting in pulmonary edema in a patient with discrete subvalvular aortic stenosis--a case report and literature review.

    This report concerns an apparently healthy elderly woman who presented with gradually worsening mitral regurgitation secondary to chordae tendineae rupture leading to pulmonary edema in the presence of discrete subvalvular aortic stenosis with a severe gradient reflecting the left ventricular outflow tract obstruction. The gradual worsening of heart failure took place parallel to the increase in severity of mitral regurgitation in a short period. The patient underwent successful mitral valve replacement with myectomy. Surgical inspection revealed rupture of the chordae tendineae to the posterior leaflets without any significant primary intrinsic disease of the mitral valve. The predominant mechanism of chordae tendineae rupture in this patient with discrete subvalvular aortic stenosis is a severe pressure gradient. It is suggested that increased awareness of chordae tendineae rupture as a cause of mitral regurgitation and the prompt use of appropriate diagnostic tools may facilitate the timely recognition of this potentially fatal, but treatable, cause of mitral regurgitation in patients with left ventricular outflow tract obstruction.
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ranking = 5.8140803255903
keywords = subvalvular, stenosis
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14/82. Successful repair of supravalvular aortic stenosis with ostial stenosis of the left coronary artery using Brom's three patch technique.

    Stenotic lesion of the left coronary artery is an unnoticed but complicating feature of supravalvular aortic stenosis (SAS). We present successful repair of SAS with left coronary ostial stenosis. A 9-year-old girl was diagnosed as williams syndrome associated with SAS. She had no symptoms of angina but cardiac catheterization revealed severe stenosis of the left coronary artery ostium. We adopted Brom's three patch technique, which could enlarge the aortic root and ostial lesion of left coronary artery inclusively. This method is also ideal regarding restoration of the aortic root geometry.
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ranking = 0.24094646498065
keywords = stenosis
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15/82. chest pain secondary to membranous subaortic stenosis in a young woman.

    Left ventricular outflow obstruction can be divided into three distinct categories: valvular aortic stenosis, the most common form; supravalvular aortic stenosis, which is often seen in early childhood; and subvalvular stenosis, which can be further subdivided into muscular, tunnel, and fibromembranous subtypes. All may be found in a patient seen with symptoms of angina, syncope, or heart failure as a precursor to sudden death. Prompt clinical recognition is essential as is a high degree of suspicion when these signs are associated with a systolic ejection murmur on clinical examination. echocardiography and a meticulous Doppler examination are very useful in the diagnosis of these disorders as well as in further distinguishing among the different subtypes. The authors describe the case of a 40-year-old woman with chest pain refractory to medical therapy and a long systolic ejection murmur.
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ranking = 1.9004387321333
keywords = subvalvular, subaortic, stenosis
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16/82. Surgical management of tunnel-like subaortic stenosis via ventricular septal defect in a patient with the interrupted aortic arch.

    A 24-day-old male with interrupted aortic arch (type B), ventricular septal defect, and tunnel-like subaortic stenosis underwent a one-stage surgical treatment. The operative procedure comprised reconstruction of the aortic arch, transatrial excision of the subaortic fibromuscular tissue via the ventricular sepatal defect, and patch closure of the defect. The patient tolerated the procedure well and the postoperative echocardiography demonstrated a residual pressure gradient across the left ventricular outflow tract of 20 mmHg. Our result suggests that the transatrial surgical management of subaortic stenosis via the ventricular sepatal defect produces a safe and promising surgical option.
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ranking = 1.5314253445349
keywords = subaortic, stenosis
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17/82. 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.
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ranking = 0.2
keywords = subaortic
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18/82. 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.
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ranking = 0.02190422408915
keywords = stenosis
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19/82. Subaortic stenosis caused by an unusual fibrous blood-filled cyst of the left ventricle with outflow tract obstruction associated with a ventricular septal defect.

    A large blood-filled cyst formed from a fibrous tissue tag of a right ventricular septal aneurysm was successfully resected. This cyst, which was causing subaortic stenosis, was attached to the margin of the closed ventricular septal defect and not to the mitral valve itself nor the papillary muscle of the left ventricle.
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ranking = 0.30952112044575
keywords = subaortic, stenosis
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20/82. Subneoaortic stenosis complicating the arterial switch operation.

    We report obstruction of the reconstructed left ventricular outflow tract diagnosed 18 months after an arterial switch operation that included closure of a ventricular septal defect. We speculate that either turbulences created by the patch used to close the ventricular septal defect, or postoperative modifications of ventricular geometry, were responsible for producing this unusual complication.
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ranking = 0.0876168963566
keywords = stenosis
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