Abstract
Bacground and Objectives: Aortic Stenosis occurs in approximately 3% to 8% of patients with congenital cardiovascular defects. Valvular AS is the most common causes of aortic stenosis and the second most common form is subvalvar aortic stenosis. Males are affected 2 to 3 times as often as females. The most common type is fibrotic form or ridge, and then fibromascular type and tunnel like is the rare form. Best surgical method for repairing is resection of obstructive lesion with myomectomy for best prevention of recurrence. There is no study in this category in Iran, so we did this study to know best time and surgical method therefore we decide to evaluate results and complications of surgery in one of popular centers of pediatric cardiac surgery in Iran with choosing best time and route of operation can inhibit progression of disease that can lead to aortic insufficiency. We hope results of this study can reduce mortality and morbidity of this disease.
Materials and Methods: all documents of patients with subaortic stenosis admitted in pediatric ward of Shahid Rajaee hospital between mehr of 1993 - 2003 studied and 279 cases included. All data coded and entered to computer and analyzed with SPSS software accordingly.
Results: 103cases (36.9%) were female and 176 cases (63.1%) were male. Mean age was 15.59±5.62 yrs. 193 cases (69.1%) operated that 83 cases (29.7%) had pressure gradient over 40mmHg and 113cases (40.5%) operated due to other cardiac diseases. Type of operation in 144 cases (74.61%) were fibrotic and fibromascular resection with or without myotomy (2cases with MVR and 3 cases with AVR), 44 cases (22.79%) fibrotic and fibromascular resection with myomectomy and 5 cases (33.33%) operated operated with Konno Rastan In this center no operation made with Ross or modified Konno. After surgery 28 cases (33/73%) had pressure gradient over 40mmHg had recurence.12 cases died during follow up.
Discussion: with respect to results of this study type of operation in this center often is fibrotic resection and fibromascular resection with or without myotomy that cumulative frequency of them is about 144 Cases (74/61%). Standard treatment of this disease is deletion of stenosis and myectomy for avoiding recurrency and frequency of this type in this center is 44 cases (22/79%) that maybe is cause of high rate of recurrence in this study.