LIXiao-feng , MAWei-guo , ZHUYao-bin , LIUAi-jun , CAOYue-feng , SUJun-wu , LILing , FANXiang-ming , LIZhi-qiang , ZHANGJing , HEYan , LIUYing-long
  • Pediatric Cardiac Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;
LIUYing-long, Email: liuyinglong@vip.sina.com
Congenial heart disease; Subaortic membrane; Surgery
10.7507/1007-4848.20140087
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Objective To summarize clinical experience and results of surgical treatment of subaortic membrane (SM). Methods Clinical data of 32 SM patients who underwent surgical resection of SM between March 2009 and September 2013 in Beijing Anzhen Hospital were retrospectively analyzed. There were 22 male and 10 female patients with their age of 0.5-14.0 (3.6±3.2)years and body weight of 5.5-43.0 (17.2±9.5)kg. Among the 32 patients, 7 patients had isolated SM, and 25 patients had other intracardiac lesions including ventricular septal defect in 21 patients, mitral regurgi-tation in 1 patient, patent ductus arteriosus (PDA)in 1 patient, SM occurrence after PDA occlusion in 1 patient and surgical correction for coarctation of the aorta in another patient. Eighteen patients had aortic insufficiency (AI)in different degree. Results SM diagnosis was missed by preoperative echocardiography in 1 patient. Mean cardiopulmonary bypass time was 71.7±21.7 minutes, aortic cross-clamping time was 48.7±15.1 minutes, ICU stay was 2.2±1.7 days, and postoperative hospital stay was 7.9±2.5 days. There was no in-hospital death in this group. Postoperatively, 1 patient had second-degree atrioventricular block which returned to sinus rhythm 6 days after the operation. All the patients were followed up for 2-54 months after discharge. During follow-up, AI of 6 patients with isolated SM was relieved, and AI of 5 SM patients with other intracardiac lesions was relieved (P=0.003). Among the 7 patients with isolated SM, preoperative moderate AI in 4 patients changed to mild AI in 3 patients and trivial AI in 1 patient, and preoperative mild AI in 3 patients changed to trivial AI in 2 patients. Among the 25 patients with other intracardiac lesions, preoperative mild AI in 8 patients changed to trivial AI in 3 patients, and preoperative moderate AI in 3 patients changed to mild AI in 1 patients and trivial AI in another patient. There was no SM recurrence during follow-up in this group. Conclusion SM diagnosis may be missed by preo-perative echocardiography, and early surgical correction is needed once the diagnosis is established. Meticulous surgical techniques are necessary during the operation. Postoperative SM recurrence may happen, so regular follow-up is required after discharge.

Citation： LIXiao-feng, MAWei-guo, ZHUYao-bin, LIUAi-jun, CAOYue-feng, SUJun-wu, LILing, FANXiang-ming, LIZhi-qiang, ZHANGJing, HEYan, LIUYing-long. Surgical Treatment of Subaortic Membrane. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(3): 307-311. doi: 10.7507/1007-4848.20140087 Copy

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