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      Echocardiography as a Predicting Method in Diagnosis, Evaluation and Assessment of Children with Subvalvar Aortic Stenosis

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          Abstract

          BACKGROUND:

          Obstruction to the left ventricular outflow of the heart may be above the aortic valve (5%), at the valve (74%), or in the subvalvar region (23%). These anomalies represent 3 to 6% of all patients with congenital heart defects (CHD), and it occurs more often in males (male-female ratio of 4:1).

          AIM:

          The purpose of this study was to determine the sensitivity and specificity of transthoracic echocardiography in diagnosis of discrete subaortic membrane, to determine convenient time for surgical intervention, and for identifying involvement of the aortic valve by subaortic shelf.

          MATERIAL AND METHODS:

          A retrospective review of the medical records and echocardiograms of 18 patients [14 male (77%) and 4 female (23%)] with discrete subaortic membrane, aged 11 month to 12 years, with mean age of 5 years and 3 month, diagnosed at the Pediatric Clinic in Prishtina, during the period September, 1999 and December, 2010 were done.

          RESULTS:

          Four patients, in neonatal age were operated from critical coarctation of the aorta and, initial signs of congestive heart failure were presented. 2 of them were operated in Belgrade, Serbia and 2 in Lausanne, Switzerland.

          CONCLUSION:

          In all presented patients bicuspid aortic valve was noted, but none of them subaortic membrane was registered.

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          Most cited references 22

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          Fixed subaortic stenosis: anatomical spectrum and nature of progression.

          Retrospective echocardiographic review identified 58 consecutive infants and children with fixed subaortic stenosis. Mean (SD) age at diagnosis was 4.8 (3.6) years (range two days to 14.7 years), and diagnosis occurred in infancy in eight. Associated cardiac abnormalities were present in 41 (71%) whereas fixed subaortic stenosis was an isolated lesion in 17 (29%). Four types of fixed subaortic stenosis were identified: short segment (47 (81%)), long segment (7 (12%)), posterior displacement of the infundibular septum with additional discrete narrowing of the left ventricular outflow tract (3 (5%)), and redundant tissue arising from the membranous septum (1 (2%)). Echocardiographic studies had been performed before the diagnosis of fixed subaortic stenosis in nine patients, all with associated abnormalities. These were performed in infancy in each and showed a "normal" left ventricular outflow tract in six and posterior deviation of the infundibular septum in three. In 16 patients serial echocardiographic studies had been performed after the diagnosis of fixed subaortic stenosis but before surgery of the left ventricular outflow tract. Rapid evolution of short segment to long segment narrowing was seen in one patient, and tethering of the aortic valve or mitral valve developed in a further four patients. Aortic valve or mitral valve involvement was not seen before the age of three years but was common thereafter (10/40 patients, 25%). Fixed subaortic stenosis may be an "acquired" lesion with the potential for changes in form as well as progression in severity of left ventricular outflow tract obstruction.
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            Benefits of early surgical repair in fixed subaortic stenosis.

            We sought to determine whether early resection can improve outcome in fixed subaortic stenosis.
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              • Abstract: found
              • Article: not found

              Risk factors for reoperation after repair of discrete subaortic stenosis in children.

              This study aimed to identify independent predictors of reoperation after successful resection of discrete subaortic stenosis (DSS).
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                Author and article information

                Journal
                Open Access Maced J Med Sci
                Open Access Maced J Med Sci
                Open Access Macedonian Journal of Medical Sciences
                Institute of Immunobiology and Human Genetics (Republic of Macedonia )
                1857-9655
                15 March 2016
                20 January 2016
                : 4
                : 1
                : 74-78
                Affiliations
                [1 ] Division of Cardiology, Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo
                [2 ] Main Center of Family Medicine, Prishtina, Republic of Kosovo
                Author notes
                [* ] Correspondence: Ramush Bejiqi. Division of Cardiology, Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo. Tel: +37744120129. E-mail: rbejiqi@ 123456hotmail.com
                Article
                OAMJMS-4-74
                10.3889/oamjms.2016.016
                4884257
                27275334
                Copyright: © 2016 Ramush Bejiqi, Hana Bejiqi, Ragip Retkoceri.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                Categories
                Clinical Science

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