La chirurgie du diaphragme sous aortique

Subaortic diaphragm is characterized by a certain clinical latency and low morbi-mortality. Surgery remains the treatment of choice despite the real risk of long-term recurrence. Our study involved 18 patients with subaortic diaphragm operated between April 1994 and March 2011. The average age was 18.1 ± 9.7 years, 11 patients were male. The diaphragm was fibrous in 13 patients and fibromuscular in 5 patients. All patients underwent diaphragm resection associated with myectomy, aortic plasty, closure of ventricular septal defect and permeable ductus arteriosus ligation in 3, 3, 2 and 2 patients respectively. Operative mortality was zero and there were no cases of postoperative conduction disorder. With a median follow-up of 44.3±36.8 months, there was no late death. Two patients had a diaphragm recurrence which required reoperation with good evolution. The current trend in diaphragm surgery is towards early interventions and more extensive resections. However, the risk of recurrence requires a systematic and close ultrasound monitoring.