Severe Valvular Aortic Stenosis and Fixed Subvalvular Aortic Stenosis: A Rare and Challenging Combination

Department

Internal Medicine

Document Type

Article

Publication Title

The Journal of Heart Valve Disease

Abstract

A 58-year-old man with a history of hypertension presented with accelerating angina. Transthoracic echocardiography revealed a thickened aortic valve with pressure gradients and an estimated aortic valve area suggestive of mild aortic stenosis. Left heart catheterization demonstrated non-significant coronary artery disease. Pressure tracings showed a high left ventricular pressure and a mean gradient across the aortic valve of 69 mmHg. Subsequent transesophageal echocardiography revealed a subvalvular aortic stenosis that was secondary to the subaortic membrane, with severe valvular aortic stenosis. The patient underwent surgical resection of the subaortic membrane followed by bioprosthetic aortic valve replacement, with resolution of his symptoms. Video 1: Transesophageal echocardiography, five-chamber view, showing the calcified aortic valve and subaortic membrane. Video 2: Transesophageal echocardiography, long-axis view, showing aliasing of the aortic flow at valvular and subvalvular levels.

First Page

240

Last Page

242

Volume

26

Issue

2

Publication Date

3-1-2017

Medical Subject Headings

Aortic Stenosis, Subvalvular (complications, diagnostic imaging, physiopathology, surgery); Aortic Valve (diagnostic imaging, physiopathology, surgery); Aortic Valve Stenosis (complications, diagnostic imaging, physiopathology, surgery); Bioprosthesis; Cardiac Catheterization; Echocardiography, Doppler; Echocardiography, Transesophageal; Heart Valve Prosthesis; Heart Valve Prosthesis Implantation (instrumentation); Hemodynamics; Humans; Male; Middle Aged; Recovery of Function; Treatment Outcome

PubMed ID

28820560

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