A case of a univentricular heart developed subaortic stenosis after fontan operation

Shingo Kasahara, S. Nakae, M. Kawada, Z. B. Lin, Y. Suzuki, H. Yoshimura

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)83-88
Number of pages6
JournalJournal of the Japanese Association for Thoracic Surgery
Volume44
Issue number1
Publication statusPublished - Jan 1996
Externally publishedYes

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Fontan Procedure
Pathologic Constriction
Ventricular Heart Septal Defects
Heart Ventricles
Systolic Murmurs
Transposition of Great Vessels
Aortic Coarctation
Pituitary Gland
Hypertrophy
Pulmonary Artery
Compliance
Quality of Life
Pressure

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

A case of a univentricular heart developed subaortic stenosis after fontan operation. / Kasahara, Shingo; Nakae, S.; Kawada, M.; Lin, Z. B.; Suzuki, Y.; Yoshimura, H.

In: Journal of the Japanese Association for Thoracic Surgery, Vol. 44, No. 1, 01.1996, p. 83-88.

Research output: Contribution to journalArticle

Kasahara, Shingo ; Nakae, S. ; Kawada, M. ; Lin, Z. B. ; Suzuki, Y. ; Yoshimura, H. / A case of a univentricular heart developed subaortic stenosis after fontan operation. In: Journal of the Japanese Association for Thoracic Surgery. 1996 ; Vol. 44, No. 1. pp. 83-88.
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