The recognition, identification of morphologic substrate, and treatment of subaortic stenosis after a Fontan operation: An analysis of twelve patients

摘要: Twelve children were identified with subaortic stenosis after Fontan's operation. All had absent resting and isoproterenol-provoked pressure gradient before the Fontan procedure. Six a univentricular heart of left ventricular morphology, three single ventricle right one tricuspid atresia transposition great arteries, pulmonary atresia, intact septum, hypoplastic ventricle, corrected systemic ventricle. The median interval between operation recognition was 2.5 years. Ten patients underwent surgical treatment prior operation: Five myectomy enlargement septal defect two operative deaths; placement valved conduit from apex to descending aorta, both died postoperatively; myectomy, aortic connection. Complete block developed in only patient. Postoperative testing Doppler echocardiography color flow imaging demonstrated good relief stenosis. six who survived are well 4 months years later. Subaortic is progressive lesion that may develop Its continues carry significant mortality. Myectomy achieve direct obstruction minimal risk block.