Left Ventricular Outflow Tract Obstruction

Abstract

Left ventricular outflow tract (LVOT) obstruction is a general term that includes all the obstructive lesions affecting the left ventricle and the aortic arch. Subaortic stenosis can be caused by fibrous rings, hypertrophied muscle, or abnormal mitral valve attachments. Aortic valve lesions can be caused by a small aortic annulus or fused leaflets. Supravalvar aortic stenosis can be caused by a fibrous ring surrounding the commissural attachments of the aortic valve. The aortic arch can be malformed by a small ascending or transverse arch, coarctation of the aorta, or interruption of the aortic arch. In addition to LVOT obstruction, aortic regurgitation can occur in association with stenosis or in isolation without obstruction. These problems tend to be lifelong problems that often require multiple operations, anticoagulation, and decongestive therapy. Each disease entity has associated reparative operations.