3 results
Transthoracic echocardiography does not reliably predict involvement of the aortic valve in patients with a discrete subaortic shelf
- Justin H. Booth, Roosevelt Bryant III, Susan C. Powers, Shuping Ge, E. Dean McKenzie, Jeffrey S. Heinle, Charles D. Fraser, Jr, David L. S. Morales
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- Journal:
- Cardiology in the Young / Volume 20 / Issue 3 / June 2010
- Published online by Cambridge University Press:
- 26 April 2010, pp. 284-289
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Background
A discrete subaortic membrane cannot only cause left ventricular outflow tract obstruction, but can grow onto the aortic valve leaflets. The late finding of this encroachment is aortic valve insufficiency or stenosis. Echocardiography is used to follow the progression of outflow tract obstruction, but its ability to show subaortic membrane encroachment onto the aortic valve is unclear. The purpose of this study is to determine the sensitivity and specificity of echocardiography for diagnosing whether a discrete subaortic membrane involves the aortic valve.
MethodsA pre-operative determination of aortic valve involvement by a discrete subaortic membrane was obtained by review of the official pre-operative echocardiogram reading and a retrospective blinded review of the pre-operative echocardiogram by an independent echocardiographer. These findings were compared to the intra-operative findings.
ResultsA total of 48 consecutive patients underwent primary resection for isolated discrete subaortic membrane between October, 1995 and May, 2006. The pre-operative and blinded readings both predicted a statistically lower rate of aortic valve involvement – 35% in 11 of 31 patients and 31% in 10 of 31 patients, respectively – than found at surgery – 65% in 31 of 48 patients. The sensitivity and specificity of pre-operative echocardiography to diagnose aortic valve involvement is 35% and 76%. Overall survival was 100%. There were no strokes, re-operations for bleeding or wound infections, or need for a pacemaker.
ConclusionEchocardiography is not sensitive in assessing whether a discrete subaortic membrane involves the aortic valve. Since the morbidity and mortality for discrete subaortic membrane resection is negligible, resection may be indicated at the time of diagnosis to minimise aortic valve impairment.
Contributors
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- By Farook Al-Azzawi, Wita Angrianni, Sanjay Asthana, Stephan Bandelow, Kathryn J. Bryan, Cynthia M. Carlsson, Jenna C. Carroll, Gemma Casadesus, Monique M. Cherrier, Laura H. Coker, María M. Corrada, Vita Priantina Dewi, Roberta Diaz Brinton, Mark A. Espeland, Mirjam I. Geerlings, Robert B. Gibbs, Carey E. Gleason, Victor W. Henderson, Patricia E. Hogan, Eef Hogervorst, Claudia H. Kawas, Anna Khaylis, Philip Kreager, Linda Kushandy, Donald Lehmann, Jin Li, Mary E. McAsey, Pauline M. Maki, Ralph N. Martins, Scott D. Moffat, Majon Muller, Theresia Ninuk, Annlia Paganini-Hill, George Perry, Christian J. Pike, Bevin N. Powers, Tri Budi W. Rahardjo, Natalie L. Rasgon, Susan M. Resnick, Emily R. Rosario, Sabarinah, Tony Sadjimim, Barbara B. Sherwin, Sally A. Shumaker, Mark A. Smith, Robert G. Struble, Chris Talbot, Wulf H. Utian, Giuseppe Verdile, Robert B. Wallace, Whitney Wharton, Katherine E. Williams, Oliver T. Wolf, Tonita E. Wroolie, Amina Yesufu, Yudarini, Liqin Zhao
- Edited by Eef Hogervorst, Loughborough University, Victor W. Henderson, Stanford University, California, Robert B. Gibbs, University of Pittsburgh, Roberta Diaz Brinton, University of Southern California
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- Book:
- Hormones, Cognition and Dementia
- Published online:
- 06 July 2010
- Print publication:
- 24 September 2009, pp vii-x
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Contributors
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- By Nalini Vadivelu, Christian J. Whitney, Raymond S. Sinatra, M. Khurram Ghori, Yu-Fan (Robert) Zhang, Raymond S. Sinatra, Joshua Wellington, Yuan-Yi Chia, Francis J. Keefe, Jon McCormack, Ian Power, John Butterworth, P. M. Lavand’homme, M. F. De Kock, Bradley Urie, Oscar A. de Leon-Casasola, Frederick M. Perkins, Larry F. Chu, David Clark, Martin S. Angst, Cynthia M. Welchek, Lisa Mastrangelo, Raymond S. Sinatra, Richard Martinez, Scott S. Reuben, Asokumar Buvanendran, Raymond S. Sinatra, Pamela E Macintyre, Julia Coldrey, Daniel B. Maalouf, Spencer S. Liu, Susan Dabu-Bondoc, Samantha A. Franco, Raymond S. Sinatra, James Benonis, Jennifer Fortney, David Hardman, Gavin Martin, Holly Evans, Karen C. Nielsen, Marcy S. Tucker, Stephen M. Klein, Benjamin Sherman, Ikay Enu, Raymond S. Sinatra, James W. Heitz, Eugene R. Viscusi, Jonathan S. Jahr, Kofi N. Donkor, Raymond S. Sinatra, Manzo Suzuki, Johan Raeder, Vegard Dahl, Stefan Erceg, Keun Sam Chung, Kok-Yuen Ho, Tong J. Gan, Dermot R. Fitzgibbon, Paul Willoughby, Brian E. Harrington, Joseph Marino, Tariq M. Malik, Raymond S. Sinatra, Giorgio Ivani, Valeria Mossetti, Simona Italiano, Thomas M. Halaszynski, Nousheh Saidi, Javier Lopez, Kate Miller, Ferne Braveman, Jaya L. Varadarajan, Steven J. Weisman, Sukanya Mitra, Raymond S. Sinatra, Theodore J. Saclarides, Knox H. Todd, James R. Miner, Chris Pasero, Nancy Eksterowicz, Margo McCaffery, Leslie N. Schechter, Amr E. Abouleish, Govindaraj Ranganathan, Tee Yong Tan, Stephan A. Schug, Marie N. Hanna, Spencer S. Liu, Christopher L. Wu, Craig T. Hartrick, Garen Manvelian, Christine Miaskowski, Brian Durkin, Peter S. A. Glass
- Edited by Raymond S. Sinatra, Oscar A. de Leon-Cassasola, University of Rochester Medical Center, New York, Eugene R. Viscusi, Brian Ginsberg
- Foreword by Henry McQuay
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- Book:
- Acute Pain Management
- Published online:
- 26 October 2009
- Print publication:
- 27 April 2009, pp vii-xii
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