Supravalvular Aortic Stenosis
نویسندگان
چکیده
BEFORE Denie and Verheugt (1958)' drew attention to the possibility of diagnosing supravalvular aortic stenosis from the characteristics of the pressure tracings across the aortic valve region, there had been only autopsy reports of 17 cases with supravalvular obstruction. Fourteen of these earlier accounts concern bands or membranes stretching across the aortic lumen2-'0 and only three previous cases1-13 are strictly comparable to Denie and Verheugt's patient, in whom the obstruction was due in part to hypertrophy of the media just above the sinuses of Valsalva and in part to constriction of the aortic wall at the same level. This patient presented the usual features of valvular or subvalvular aortic stenosis and the true condition was not recognized until operation. Denie and Verheugt commented that "as surgical correction of the aortic stenosis becomes more commonplace, . . . these anomalies may well be encountered more frequently." Subsequently, Morrow et al.'4 reported three similar cases, of which two were unsuspected until operation but one was diagnosed preoperatively by left heart catheterization. Angiocardiograms taken after retrograde left ventricular catheterization in two further cases were published by Hanson et al.'5 and by Dotter and Gensini,16 and with the aid of cardiopulmonary bypass MeGoon et al.'7 and Senning18 have successfully relieved obstructions of this type. Four new instances of this anomaly to which the term supravalvular aortic stenosis is becoming specifically applied are now reported. In three patients, who otherwise had the signs of valvular or subvalvular stenosis, the correct diagnosis was suggested before investigation by the close facial resemblance
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