Pediatric Subvalvar Aortic Stenosis Differential Diagnoses

  • Author: Douglas J Schneider, MD; more...
 
Updated: Mar 29, 2011
 
 

Diagnostic Considerations

Other coexistent defects (eg, ventricular septal defect [VSD], coarctation of the aorta, interrupted aortic arch, Shone complex, atrioventricular septal defects) must be considered in patients with subvalvar aortic stenosis.

Symptoms of associated congenital heart defects frequently mask those of SAS.

Differential Diagnoses

Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Douglas J Schneider, MD  Associate Professor of Pediatrics, Clinical Tract, Division of Pediatric Cardiology, Department of Pediatrics, University of Kentucky College of Medicine; Director, Pediatric Cardiac Catheterization Laboratory, Kentucky Children's Hospital

Disclosure: Nothing to disclose.

Coauthor(s)

Gautam K Singh, MD, DCh, MRCP, FACC  Associate Professor of Pediatrics, Division of Cardiology, Director of Noninvasive Imaging Research, Co-director of Echocardiography Laboratory, Washington University School of Medicine; Attending Faculty, Department of Pediatrics, Division of Cardiology, St Louis Children's Hospital

Gautam K Singh, MD, DCh, MRCP, FACC is a member of the following medical societies: American College of Cardiology, American Heart Association, American Society of Echocardiography, and Royal College of Physicians

Disclosure: Nothing to disclose.

Specialty Editor Board

Paul M Seib, MD  Associate Professor of Pediatrics, University of Arkansas for Medical Sciences; Medical Director, Cardiac Catheterization Laboratory, Co-Medical Director, Cardiovascular Intensive Care Unit, Arkansas Children's Hospital

Paul M Seib, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, American Heart Association, Arkansas Medical Society, International Society for Heart and Lung Transplantation, and Society for Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Pharmacy Editor, eMedicine

Disclosure: Nothing to disclose.

John W Moore, MD, MPH  Professor of Clinical Pediatrics, Section of Pediatric Cardiology, Department of Pediatrics, University of California San Diego School of Medicine; Director of Cardiology, Rady Children's Hospital

John W Moore, MD, MPH is a member of the following medical societies: American Academy of Pediatrics, American College of Cardiology, and Society for Cardiac Angiography and Interventions

Disclosure: Nothing to disclose.

References

  1. Iwata Y, Imai Y, Shin'oka T, Kurosawa H. Subaortic stenosis associated with systolic anterior motion. Heart Vessels. Nov 2008;23(6):436-9. [Medline].

  2. Somerville J, Stone S, Ross D. Fate of patients with fixed subaortic stenosis after surgical removal. Br Heart J. Jun 1980;43(6):629-47. [Medline]. [Full Text].

  3. Bezold LI, Smith EO, Kelly K, et al. Development and validation of an echocardiographic model for predicting progression of discrete subaortic stenosis in children. Am J Cardiol. Feb 1 1998;81(3):314-20. [Medline].

  4. Edwards JE. Pathology of left ventricular outflow tract obstruction. Circulation. Apr 1965;31:586-99. [Medline].

  5. Barkhordarian R, Wen-Hong D, Li W, et al. Geometry of the left ventricular outflow tract in fixed subaortic stenosis and intact ventricular septum: an echocardiographic study in children and adults. J Thorac Cardiovasc Surg. Jan 2007;133(1):196-203. [Medline].

  6. Kleinert S, Geva T. Echocardiographic morphometry and geometry of the left ventricular outflow tract in fixed subaortic stenosis. J Am Coll Cardiol. Nov 1 1993;22(5):1501-8. [Medline].

  7. Newfeld EA, Muster AJ, Paul MH, et al. Discrete subvalvular aortic stenosis in childhood. Study of 51 patients. Am J Cardiol. Jul 1976;38(1):53-61. [Medline].

  8. Wright GB, Keane JF, Nadas AS, et al. Fixed subaortic stenosis in the young: medical and surgical course in 83 patients. Am J Cardiol. Oct 1 1983;52(7):830-5. [Medline].

  9. Suri RM, Dearani JA, Schaff HV, Danielson GK, Puga FJ. Long-term results of the Konno procedure for complex left ventricular outflow tract obstruction. J Thorac Cardiovasc Surg. Nov 2006;132(5):1064-71. [Medline].

  10. Karamlou T, Gurofsky R, Bojcevski A, et al. Prevalence and associated risk factors for intervention in 313 children with subaortic stenosis. Ann Thorac Surg. Sep 2007;84(3):900-6; discussion 906. [Medline].

  11. Rohlicek CV, del Pino SF, Hosking M, Miro J, Côté JM, Finley J. Natural history and surgical outcomes for isolated discrete subaortic stenosis in children. Heart. Dec 1999;82(6):708-13. [Medline]. [Full Text].

  12. Gersony WM. Natural history of discrete subvalvar aortic stenosis: management implications. J Am Coll Cardiol. Sep 2001;38(3):843-5. [Medline].

  13. Brauner R, Laks H, Drinkwater DC Jr, Shvarts O, Eghbali K, Galindo A. Benefits of early surgical repair in fixed subaortic stenosis. J Am Coll Cardiol. Dec 1997;30(7):1835-42. [Medline].

  14. Singh GK, Shiota T, Cobanoglu A, et al. Diagnostic accuracy and role of intraoperative biplane transesophageal echocardiography in pediatric patients with left ventricle outflow tract lesions. J Am Soc Echocardiogr. Jan 1998;11(1):47-56. [Medline].

  15. Brown JW, Ruzmetov M, Vijay P, et al. Operative results and outcomes in children with Shone's anomaly. Ann Thorac Surg. Apr 2005;79(4):1358-65. [Medline].

  16. [Guideline] Bonow RO, Carabello BA, Kanu C, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. Aug 1 2006;114(5):e84-231. [Medline].

 
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Echocardiogram of membranous subaortic stenosis. AO = aortic; LA = left atrium; LVOT = left ventricular outflow tract.
Tunnel-type of subaortic stenosis (subvalvular aortic stenosis [SAS]). MV = mitral valve.
 
 
 
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