الفهرس | Only 14 pages are availabe for public view |
Abstract 4.1.Subaortic membrane was first recognized by Chevers, 1842. It encompasses between 830% of the cases of left ventricular outflow tract obstruction. 4.2.AIM OF THE WORK: The aim of this study is to analyse the results of the surgical excision of subaortic membrane clinically, by chest x ray and echocardiography, to evaluate the different techniques of the surgical treatment of subaortic membrane and to detect the high risk factors , recurrences and complications. 4.3.MEHODS: This prospective study included 56 patients with subaortic membrane operated upon in the period between June 2000 and June 2002 in 3 cardiac surgery centers in Mansoura University Hospitals (Egypt) , San Raffaele and San Donato Milanese Hospitals (Milano, Italy). 4.4.RESULTS: Our series showed complete relief of symptoms in 20 patients (35.7%) with marked relief of symptoms in the remaining 24 patients. The commonest residual symptom was dyspnoea which was present in 13 patients (23.2%). Palpitation and headache were present in 12 patients (21.4%). Blurring of vision was seen in 10 patients. Syncope was seen in 4 patients. The residual symptoms were mainly observed with the group of membranectomy alone. The systolic thrill and murmur disappeared after myomectomy in 80%. (it is present postoperatively in only 20%), disappeared less after membranectomy alone (66.66%) and the least (60%) after myotomy. 4.5.Conclusion: Early Resection of the subaortic membrane with myotomy and myomectomy whatever the pressure gradient or the age of the patients, gives the best short and long term functional, radiographic and echocardiographic results provided that the surgeon has a familiarity with the LVOT structures, with available perfusion team well equipped and well trained to manage the low body weight patients. Further follow up of our cases is needed to detect the recurrences and treat the complications as early as possible and to follow the changes in the left ventricular functions. |