Abstract
Heart failure with preserved left ventricular ejection fraction. Revision of exceptional case of valvular and subvalvular aortic obstruction
Highlights
Fixed aortic subvalvular stenosis is a rare congenital anomaly that represents 1% of all congenital heart defects [1]
Fixed aortic subvalvular stenosis may be due to a discrete fibrous membrane, muscle narrowing or a combination of both [1]
Rosenquist, et al found that the distance between the mitral and aortic valves in patients with aortic subvalvular stenosis is constantly increasing
Summary
Fixed aortic subvalvular stenosis is a rare congenital anomaly that represents 1% of all congenital heart defects [1]. Transthoracic and transesophageal echocardiography demonstrated: A bicuspid aortic valve type 3 with fusion of the non-coronary leaflet and right coronary leaflet A subvalvular stenosis due to subaortic fibrous ridge and accessory mitral tissue (Figures 2 and 3) with a maximum velocity of 5.1 m/s, a maximum gradient 104 mmHg and average gradient of 55 mmHg Significant aortic insufficiency with vena contracta of 7.5 mm (Figure 3) Moderate mitral regurgitation (Figure 3) A permeable oval foramen (Figure 2) On the other hand, the echocardiography showed severe asymmetric septal hypertrophy with a basal thickness of 22 mm, relative parietal thickness of 1.49 and left ventricular mass index of 199 gr / m2, left ventricular ejection fraction of 70%, type I diastolic dysfunction and normal pulmonary artery systolic pressure. The patient is in NYHA I functional class, with periodic follow-up in the outpatient clinic
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