Idiopathic Hypertrophic Subaortic Stenosis; Surgical Treatment

¹ Thoracic-Cardiovascular Surgery Department and the Cardiopulmonary Laboratory, Beilinson Hospital (Petah-Tiqva) Tel Aviv, and University of Tel-Aviv Medical School, Israel

Nine patients (seven men and two women) with idiopathic hypertrophic subaortic stenosis have been operated upon in the last 4 years utilizing extracorporeal circulation. Their ages ranged from 32 to 47 years. In each patient, the diagnosis was established by detailed clinical, catheterization data and left ventricular angiocardiography. The operative technic consisted of septotomy in two cases or septectomy via the aorta in seven. In one patient, additional portions of the septum were removed through a right ventricular approach. All patients survived the operation and have been observed for a period that ranged from one to 4 years. The mean peak systolic gradient of all the patients dropped from 96 mm Hg before operation to 14 mm Hg after. Amelioration of symptoms and improvement of functional capacity have been most striking. Dramatic results of operation in rehabilitating patients to a normal life and the absence of mortality in this small series may constitute strong stimulation to utilizing surgical treatment in some patients with idiopathic hypertrophic subaortic stenosis not responding to medical management.