[A case of a univentricular heart developed subaortic stenosis after fontan operation]. 1996

S Kasahara, and S Nakae, and M Kawada, and Z B Lin, and Y Suzuki, and H Yoshimura
Department of Thoracid and Cardiovascular Surgery, Kitasato University School of Medicine, Kanagawa, Japan.

The patient was a seven-old-boy with univentricular heart of left ventricular morphology with transposition of the great arteries and coarctation of the Aorta. Pulmonary artery banding and coarctactomy (subclavian flap method) were performed as prior surgery during infancy and significant subaortic stenosis (SAS) was not identified before or immediately after Fontan operation. SAS was suspected in an ejection murmur that developed without symptoms two years and five months after Fontan operation. It became clear that the SAS was caused by both restrictive ventricular septal defect and narrowing of outlet chamber (right ventricle). Surgery was performed with myectomy in the outlet chamber, enlargement of ventricular septal defect and a patch enlargement of the right ventricle outflow tract for relief of the SAS. Postoperative pressure gradient across the subaortic component was decreased, however, valve regurgitation remained grade I to II. The mechanisms of SAS after Fontan operation are related to hypertrophy of the subaortic component that incorporates the infundibulum and trabeculae. Careful morphological investigation is essential in patients with risk factors for SAS Mild deterioration of the ventricular compliance due to progressive SAS may result in reduction of the cardiac function and patient's quality of life. Adequate surgical treatment to relieve the SAS is considered essential before and after Fontan operation.

UI MeSH Term Description Entries
D008297 Male Males
D011183 Postoperative Complications Pathologic processes that affect patients after a surgical procedure. They may or may not be related to the disease for which the surgery was done, and they may or may not be direct results of the surgery. Complication, Postoperative,Complications, Postoperative,Postoperative Complication
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006352 Heart Ventricles The lower right and left chambers of the heart. The right ventricle pumps venous BLOOD into the LUNGS and the left ventricle pumps oxygenated blood into the systemic arterial circulation. Cardiac Ventricle,Cardiac Ventricles,Heart Ventricle,Left Ventricle,Right Ventricle,Left Ventricles,Right Ventricles,Ventricle, Cardiac,Ventricle, Heart,Ventricle, Left,Ventricle, Right,Ventricles, Cardiac,Ventricles, Heart,Ventricles, Left,Ventricles, Right
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001017 Aortic Coarctation A birth defect characterized by the narrowing of the AORTA that can be of varying degree and at any point from the transverse arch to the iliac bifurcation. Aortic coarctation causes arterial HYPERTENSION before the point of narrowing and arterial HYPOTENSION beyond the narrowed portion. Coarctation of Aorta,Coarctation of Aorta Dominant,Coarctation of the Aorta,Aorta Coarctation,Aorta Coarctations,Aorta Dominant Coarctation,Aorta Dominant Coarctations,Aortic Coarctations,Coarctation, Aortic,Coarctations, Aortic
D001020 Aortic Stenosis, Subvalvular A pathological constriction occurring in the region below the AORTIC VALVE. It is characterized by restricted outflow from the LEFT VENTRICLE into the AORTA. Aortic Subvalvular Stenosis,Subvalvular Aortic Stenosis,Aortic Stenoses, Subvalvular,Aortic Subvalvular Stenoses,Stenoses, Aortic Subvalvular,Stenoses, Subvalvular Aortic,Stenosis, Aortic Subvalvular,Stenosis, Subvalvular Aortic,Subvalvular Aortic Stenoses,Subvalvular Stenoses, Aortic,Subvalvular Stenosis, Aortic
D014188 Transposition of Great Vessels A congenital cardiovascular malformation in which the AORTA arises entirely from the RIGHT VENTRICLE, and the PULMONARY ARTERY arises from the LEFT VENTRICLE. Consequently, the pulmonary and the systemic circulations are parallel and not sequential, so that the venous return from the peripheral circulation is re-circulated by the right ventricle via aorta to the systemic circulation without being oxygenated in the lungs. This is a potentially lethal form of heart disease in newborns and infants. Dextro-TGA,Dextrotransposition of Great Vessels,Levo-Looped Transposition of the Great Arteries,Levo-TGA,Levotransposition of Great Vessels,Dextro-Looped Transposition of the Great Arteries,Transposition of Great Arteries,Dextro Looped Transposition of the Great Arteries,Dextro TGA,Dextro-TGAs,Great Arteries Transposition,Great Arteries Transpositions,Great Vessels Dextrotransposition,Great Vessels Dextrotranspositions,Great Vessels Levotransposition,Great Vessels Levotranspositions,Great Vessels Transposition,Great Vessels Transpositions,Levo Looped Transposition of the Great Arteries,Levo TGA,Levo-TGAs
D018729 Fontan Procedure A procedure in which total right atrial or total caval blood flow is channeled directly into the pulmonary artery or into a small right ventricle that serves only as a conduit. The principal congenital malformations for which this operation is useful are TRICUSPID ATRESIA and single ventricle with pulmonary stenosis. Fontan Circuit,Fontan Circulation,Fontan Operation,Fontan Palliation,Hemi-Fontan Procedure,Bidirectional Cavopulmonary Shunt,Bidirectional Glenn Procedure,Bidirectional Glenn Shunt,Norwood Procedure, Stage 2,Norwood Procedure, Stage 3,Norwood Procedure, Stage II,Norwood Procedure, Stage III,Stage 2 Norwood Procedure,Stage 3 Norwood Procedure,Stage II Norwood Procedure,Stage III Norwood Procedure,Bidirectional Cavopulmonary Shunts,Bidirectional Glenn Procedures,Bidirectional Glenn Shunts,Cavopulmonary Shunt, Bidirectional,Circuit, Fontan,Circulation, Fontan,Glenn Procedure, Bidirectional,Glenn Shunt, Bidirectional,Hemi Fontan Procedure,Operation, Fontan,Palliation, Fontan,Procedure, Bidirectional Glenn,Procedure, Fontan,Procedure, Hemi-Fontan,Shunt, Bidirectional Cavopulmonary

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