The Annals of Thoracic Surgery, Vol 27, 335-339, Copyright © 1979 by The Society of Thoracic Surgeons
Acquired supravalvular aortic stenosis
WG Williams, J Mathieu, G Culham, GA Trusler and PM Olley
Severe supravalvular aortic stenosis was discovered at reoperation in 3
children with recurrent stenosis of the left ventricular outflow tract. The
lesion consisted of gross thickening of the sinus ridge, most marked at the
site of the previous aortotomy. The thickening had shortened the free edge
of one or more leaflets and had distorted adjacent commissures.
Preoperative angiography had indicated valve stenosis, but little
commissural fusion was found at operation and the outflow tract obstruction
was relieved by inserting a prosthetic patch in the ascending aorta.
Recognition of this iatrogenic pathology is important to avoid
supravalvular stenosis after aortic valvotomy and unnecessary valve
replacement in children requiring reoperation for recurrent left
ventricular outflow tract obstruction.