분리성 대동맥판막하 협착의 수술

Surgery for Discrete Subaortic Stenosis

Concerning the operative technique for the relief of discrete subvalvular aortic stenosis, emphasis by some authors has been placed on the superiority of blunt dissection in the enucleation of the entire, obstructing structure such as membranous or fibrous ring stenosis compared with the conventional resection by sharp dissection technique. Here report a case operated applying the technique of blunt dissection, analogous to endarterectomy, which resulted in good clinical improvement. The technique is such that the tissue causing obstruction is peeled off the ventricular septum along the plane of cleavage using a dissector, starting under the commissure between right and left coronary cusps. As for the origin of stenosis this case imply a possibility of different mechanism of etiology evidenced by that the tissue removed consisted of elastic fibers only.