Echocardiographic predictors of the need for infundibular wedge resection in infants with aortic arch obstruction, ventricular septal defect and subaortic stenosis

Abstract

Infants with aortic arch obstruction and outlet ventricular septal defect can have posterior displacement of the infundibular septum into the left ventricular outflow tract causing varying degrees of subaortic stenosis. 1–3 Because of the large ventricular septal defect, left ventricular outflow tract velocities are frequently normal. For this reason, Doppler peak gradients are often not helpful for assessing the severity of the outflow tract narrowing preoperatively. Preoperative evaluation of the degree of subaortic obstruction and, thus, the need for surgical intervention is usually based on qualitative assessment of the anatomic 2-dimensional echocardiographic image. 2–6 This study defines 2-dimensional echocardiographic predictors of the need for subaortic resection in infants with aortic arch obstruction, outlet ventricular septal defect and posterior deviation of the infundibular septum.