Background Sinus of Valsalva aneurysm （SVA） is a rare cardiac anomaly, and SVA with discrete membranous subaortic stenosis is even rarer. The aim of the study was to make sure the incidence of SVA with discrete mem...Background Sinus of Valsalva aneurysm （SVA） is a rare cardiac anomaly, and SVA with discrete membranous subaortic stenosis is even rarer. The aim of the study was to make sure the incidence of SVA with discrete membraneous subaortic stenosis in SVA and their surgical results. We retrospectively analyzed 234 patients receiving surgical repair of SVA and reported the incidence of ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis. We also reported seven cases of SVA combined with discrete membranous subaortic stenosis and their surgical results.Methods Between January 1999 and December 2009, seven patients of SVA with discrete membranous subaortic stenosis underwent surgical repair of SVA and resection of subaortic discrete membrane. There were six male and one female patients. The mean age was （33.71±13.25） years （range 16–52 years）. Associated cardiovascular lesions were aortic regurgitation （n=7）, ventricular septal defect （n=5）, coarctation of aorta （n=1）, bicuspid aortic valve （n=1）, patent ductus arteriosus （n=1）, and aortic valve stenosis （n=1）. The aortic valve was replaced in four patients and valvuloplasty was done in three. The other co-existing anomalies were corrected at the same time. All the seven patients were followed up from 18 to 125 months （mean （63.14±39.54） months）. Among 234 SVA patients who underwent surgical repair, the number of cases with coexisting ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis was 129, 108, and 7, respectively.Results There was neither early death after operation nor late death during the follow-up period. All the seven patients were in the New York Heart Association （NYHA） functional classes I and II. There was no recurrence of discrete subaortic membrane during the follow-up period. The incidence of ventricular septal defect, aortic valve incompetence, and discrete membranous subaortic stenosis among 234 SVA patients was 55.13%, 46.15%, and 2.99%, respectively.Conclusions Surgical repair of SVA with discrete membranous subaortic stenosis showed good mid-term results. Resection of discrete subaortic membrane should be done actively while repairing SVAs. Long-term results need to be followed up.展开更多
Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectr...Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectral pattern, manifesting a sharp and high frequency peak occurring late in systole, often bearing a striking resemblance to the subaortic Doppler flow pattern. Methods: Murmurs found in thirty one subjects with dynamic subaortic stenosis were analyzed after having been recorded with a novel portable device capable of spectral and waveform sound displays. Results: All subjects manifested characteristic frequency patterns, consisting of high and sharp peaks occurring in late systole. With significant subaortic stenosis (resting subaortic flow velocity > 2 m/sec) this pattern was evident at rest. In the presence of little or no resting subaortic obstruction (< 2 m/sec) this pattern was produced regularly by the Valsalva maneuver. Conclusions: Dynamic subaortic stenosis produces a specific sound spectral pattern that may provide a basis for clinical evaluation, especially in early detection of this disorder and in screening situations.展开更多
文摘Background Sinus of Valsalva aneurysm （SVA） is a rare cardiac anomaly, and SVA with discrete membranous subaortic stenosis is even rarer. The aim of the study was to make sure the incidence of SVA with discrete membraneous subaortic stenosis in SVA and their surgical results. We retrospectively analyzed 234 patients receiving surgical repair of SVA and reported the incidence of ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis. We also reported seven cases of SVA combined with discrete membranous subaortic stenosis and their surgical results.Methods Between January 1999 and December 2009, seven patients of SVA with discrete membranous subaortic stenosis underwent surgical repair of SVA and resection of subaortic discrete membrane. There were six male and one female patients. The mean age was （33.71±13.25） years （range 16–52 years）. Associated cardiovascular lesions were aortic regurgitation （n=7）, ventricular septal defect （n=5）, coarctation of aorta （n=1）, bicuspid aortic valve （n=1）, patent ductus arteriosus （n=1）, and aortic valve stenosis （n=1）. The aortic valve was replaced in four patients and valvuloplasty was done in three. The other co-existing anomalies were corrected at the same time. All the seven patients were followed up from 18 to 125 months （mean （63.14±39.54） months）. Among 234 SVA patients who underwent surgical repair, the number of cases with coexisting ventricular septal defect, aortic regurgitation, and discrete membranous subaortic stenosis was 129, 108, and 7, respectively.Results There was neither early death after operation nor late death during the follow-up period. All the seven patients were in the New York Heart Association （NYHA） functional classes I and II. There was no recurrence of discrete subaortic membrane during the follow-up period. The incidence of ventricular septal defect, aortic valve incompetence, and discrete membranous subaortic stenosis among 234 SVA patients was 55.13%, 46.15%, and 2.99%, respectively.Conclusions Surgical repair of SVA with discrete membranous subaortic stenosis showed good mid-term results. Resection of discrete subaortic membrane should be done actively while repairing SVAs. Long-term results need to be followed up.
文摘Background: Dynamic subaortic stenosis occurs in differing situations, commonly with hypertrophic cardiomyopathy. Regardless of the underlying cause, the resulting murmurs usually possess a characteristic sound spectral pattern, manifesting a sharp and high frequency peak occurring late in systole, often bearing a striking resemblance to the subaortic Doppler flow pattern. Methods: Murmurs found in thirty one subjects with dynamic subaortic stenosis were analyzed after having been recorded with a novel portable device capable of spectral and waveform sound displays. Results: All subjects manifested characteristic frequency patterns, consisting of high and sharp peaks occurring in late systole. With significant subaortic stenosis (resting subaortic flow velocity > 2 m/sec) this pattern was evident at rest. In the presence of little or no resting subaortic obstruction (< 2 m/sec) this pattern was produced regularly by the Valsalva maneuver. Conclusions: Dynamic subaortic stenosis produces a specific sound spectral pattern that may provide a basis for clinical evaluation, especially in early detection of this disorder and in screening situations.
