Posterior deviation of left ventricular outflow tract septal components without ventricular septal defect

OBJECTIVE: To describe 11 patients with narrowing of the left ventricular outflow tract caused by angular posterior deviation of both the outlet septum and the upper part of trabecular septum, which was diagnosed by cross sectional echocardiography in all and confirmed by angiocardiography in seven....

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Veröffentlicht in:Heart (British Cardiac Society) 1997-03, Vol.77 (3), p.242-246
Hauptverfasser: Ozkutlu, S., Tokel, N. K., Saraçlar, M., Alehan, D., Yurdakul, Y., Ruacan, S.
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container_end_page 246
container_issue 3
container_start_page 242
container_title Heart (British Cardiac Society)
container_volume 77
creator Ozkutlu, S.
Tokel, N. K.
Saraçlar, M.
Alehan, D.
Yurdakul, Y.
Ruacan, S.
description OBJECTIVE: To describe 11 patients with narrowing of the left ventricular outflow tract caused by angular posterior deviation of both the outlet septum and the upper part of trabecular septum, which was diagnosed by cross sectional echocardiography in all and confirmed by angiocardiography in seven. RESULTS: Four patients had a subaortic systolic pressure gradient ranging from 23 to 70 mm Hg by Doppler echocardiography; cardiac catheterisation showed a significant (60 and 104 mm Hg) systolic pressure gradient in two. In four cases aortic regurgitation and two tricuspid pouches were shown by Doppler echocardiography, angiocardiography, or both. Four cases had a ridge at the angulation point on echocardiographic examination. Three patients were operated on for systolic pressure gradients of the left ventricular outflow tract and one for severe aortic regurgitation. There was proliferation of collagen-rich fibrous tissue in the subendocardial region on histopathological examination of the myectomy material. A ventricular septal defect had been diagnosed previously by contrast echocardiography in one patient; thus ventricular septal defects may close spontaneously over a period of time including fetal life. A subaortic ridge was detected in one patient at follow up. CONCLUSIONS: Deviation of the outlet and trabecular septa should be considered as a cause of ventricular outflow tract obstruction even when no ventricular septal defect is present.
doi_str_mv 10.1136/hrt.77.3.242
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Three patients were operated on for systolic pressure gradients of the left ventricular outflow tract and one for severe aortic regurgitation. There was proliferation of collagen-rich fibrous tissue in the subendocardial region on histopathological examination of the myectomy material. A ventricular septal defect had been diagnosed previously by contrast echocardiography in one patient; thus ventricular septal defects may close spontaneously over a period of time including fetal life. A subaortic ridge was detected in one patient at follow up. CONCLUSIONS: Deviation of the outlet and trabecular septa should be considered as a cause of ventricular outflow tract obstruction even when no ventricular septal defect is present.</description><identifier>ISSN: 1355-6037</identifier><identifier>EISSN: 1468-201X</identifier><identifier>DOI: 10.1136/hrt.77.3.242</identifier><identifier>PMID: 9093042</identifier><language>eng</language><publisher>London: BMJ Publishing Group Ltd and British Cardiovascular Society</publisher><subject>Adolescent ; Adult ; Angiocardiography ; Biological and medical sciences ; Cardiology. 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K.</creatorcontrib><creatorcontrib>Saraçlar, M.</creatorcontrib><creatorcontrib>Alehan, D.</creatorcontrib><creatorcontrib>Yurdakul, Y.</creatorcontrib><creatorcontrib>Ruacan, S.</creatorcontrib><title>Posterior deviation of left ventricular outflow tract septal components without ventricular septal defect</title><title>Heart (British Cardiac Society)</title><addtitle>Heart</addtitle><description>OBJECTIVE: To describe 11 patients with narrowing of the left ventricular outflow tract caused by angular posterior deviation of both the outlet septum and the upper part of trabecular septum, which was diagnosed by cross sectional echocardiography in all and confirmed by angiocardiography in seven. RESULTS: Four patients had a subaortic systolic pressure gradient ranging from 23 to 70 mm Hg by Doppler echocardiography; cardiac catheterisation showed a significant (60 and 104 mm Hg) systolic pressure gradient in two. In four cases aortic regurgitation and two tricuspid pouches were shown by Doppler echocardiography, angiocardiography, or both. Four cases had a ridge at the angulation point on echocardiographic examination. Three patients were operated on for systolic pressure gradients of the left ventricular outflow tract and one for severe aortic regurgitation. There was proliferation of collagen-rich fibrous tissue in the subendocardial region on histopathological examination of the myectomy material. A ventricular septal defect had been diagnosed previously by contrast echocardiography in one patient; thus ventricular septal defects may close spontaneously over a period of time including fetal life. A subaortic ridge was detected in one patient at follow up. 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Vascular system</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Echocardiography</topic><topic>Endocardial and cardiac valvular diseases</topic><topic>Heart</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Myocardium - pathology</topic><topic>Ventricular Outflow Obstruction - diagnostic imaging</topic><topic>Ventricular Outflow Obstruction - pathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ozkutlu, S.</creatorcontrib><creatorcontrib>Tokel, N. 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K.</au><au>Saraçlar, M.</au><au>Alehan, D.</au><au>Yurdakul, Y.</au><au>Ruacan, S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Posterior deviation of left ventricular outflow tract septal components without ventricular septal defect</atitle><jtitle>Heart (British Cardiac Society)</jtitle><addtitle>Heart</addtitle><date>1997-03-01</date><risdate>1997</risdate><volume>77</volume><issue>3</issue><spage>242</spage><epage>246</epage><pages>242-246</pages><issn>1355-6037</issn><eissn>1468-201X</eissn><abstract>OBJECTIVE: To describe 11 patients with narrowing of the left ventricular outflow tract caused by angular posterior deviation of both the outlet septum and the upper part of trabecular septum, which was diagnosed by cross sectional echocardiography in all and confirmed by angiocardiography in seven. 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CONCLUSIONS: Deviation of the outlet and trabecular septa should be considered as a cause of ventricular outflow tract obstruction even when no ventricular septal defect is present.</abstract><cop>London</cop><pub>BMJ Publishing Group Ltd and British Cardiovascular Society</pub><pmid>9093042</pmid><doi>10.1136/hrt.77.3.242</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central
subjects Adolescent
Adult
Angiocardiography
Biological and medical sciences
Cardiology. Vascular system
Child
Child, Preschool
Echocardiography
Endocardial and cardiac valvular diseases
Heart
Humans
Medical sciences
Myocardium - pathology
Ventricular Outflow Obstruction - diagnostic imaging
Ventricular Outflow Obstruction - pathology
title Posterior deviation of left ventricular outflow tract septal components without ventricular septal defect
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