Echocardiography as a Predicting Method in Diagnosis, Evaluation and Assessment of Children with Subvalvar Aortic Stenosis

  • Ramush Bejiqi Division of Cardiology, Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo
  • Hana Bejiqi Main Center of Family Medicine, Prishtina, Republic of Kosovo
  • Ragip Retkoceri Division of Cardiology, Pediatric Clinic, University Clinical Center of Kosovo, Prishtina, Republic of Kosovo
Keywords: congenital heart disease, aortic stenosis, subaortic membrane, hypertrophic cardiomyopathy, heart surgery


BACKGROUND: Obstruction to the left ventricular outflow of the heart may be above the aortic valve (5%), at the valve (74%), or in the subvalvar region (23%). These anomalies represent 3 to 6% of all patients with congenital heart defects (CHD), and it occurs more often in males (male-female ratio of 4:1).

AIM: The purpose of this study was to determine the sensitivity and specificity of transthoracic echocardiography in diagnosis of discrete subaortic membrane, to determine convenient time for surgical intervention, and for identifying involvement of the aortic valve by subaortic shelf.

MATERIAL AND METHODS: A retrospective review of the medical records and echocardiograms of 18 patients [14 male (77%) and 4 female (23%)] with discrete subaortic membrane, aged 11 month to 12 years, with mean age of 5 years and 3 month, diagnosed at the Pediatric Clinic in Prishtina, during the period September, 1999 and December, 2010 were done.

RESULTS: Four patients, in neonatal age were operated from critical coarctation of the aorta and, initial signs of congestive heart failure were presented. 2 of them were operated in Belgrade, Serbia and 2 in Lausanne, Switzerland.

CONCLUSION: In all presented patients bicuspid aortic valve was noted, but none of them subaortic membrane was registered.


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Rayburn ST, Netherland DE, Heath BJ. Discrete membranous subaortic stenosis: improved results after resection and myectomy. Ann Thorac Surg. 1997;64:105-109.

Serraf A, Zoghby J, Lacour – Gayet F, et al. Surgical treatment of subaortic stenosis: a seventeen-year experience. J Thorac Cardiovasc Surg. 1999;117:669-678.

Anderson RH, Baker EJ, Mccartney FJ, Rigby ML (eds). Paediatric Cardiology, 2nd ed. Philadelphia: Churchill Livingstone, 2000.

van Son JA, Schaff HV, Danielson GK, et al. Surgical treatment of discrete and tunell subaortic stenosis. Late survival and risk of reoperation. Circulation. 1993;88:II159-69.


Koz C, YokuÅŸoÄŸlu M, Baysan O, Uzun M. Obstruction of the left ventricular outflow tract caused by bicuspid aortic valve and discrete subaortic membrane. Turk Kardiyol Dern Ars. 2008;36(7):470-2.


Kelly DT, Wulfsberg E, Rowe RD. Discrete subaortic stenosis. Circulation. 1972;46:309–322.


Maréchaux S, Juthier F, Banfi C, Vincentelli A, Prat A, Ennezat PV. Illustration of the echocardiographic diagnosis of subaortic membrane stenosis in adults: surgical and live three-dimensional transoesophageal findings. Eur J Echocardiogr. 2011;12(1):E2.


Booth JH, Bryant R, Powers SC, Ge S, McKenzie ED, Heinle JS, Fraser CD, Morales DL. Transthoracic echocardiography does not reliably predict involvement of the aortic valve in patients with a discrete subaortic shelf. Cardiol Young. 2010;20(3):284-9.


Brauner R, Laks H, Drinkwater DC Jr,. et al. Benefits of early surgical repair in fixed subaortic stenosis. J Am Coll Cardiol. 1997;30:1835-42.

Douville EC, Sade RM, Crawford FA Jr, Wiles HB, Subvalvar aortic stenosis: timing for operation. Ann Thoarc Surg. 1990;50:29–33, discussion 33 – 4.

Choi JY, Sullivan ID. Fixed subaortic stenosis: anatomical spectrum and nature of progression. Br Heart J. 1991;65:280-86.

Geva A, McMahon CJ, Gauvreau K, et al. Risk factors for reoperation after repair of discrete subaortic stenosis. J Am Coll Cardiol. 2007;50:1498 – 504.


Habbal MH. Discrete subaortic stenosis in newborn. Pediatr Cardiol. 1991;12:243-244.


Leichter DA, Sullivan I. Gersony WM. " Acquired" discrete subvalvular aortic stenosis: natural history and hemodynamics. J Am Coll Cardiol. 1989:14:1539 – 44.

Skjaerpe T, Hegrenaes L, Hatle L. Non-invasive estimation of valve area in patients with aortic stenosis by Doppler ultrasound and two dimensional echocardiography. Circulation. 1985;72:810-818.


Sung CS, Price EC, Cooly DA. Discrete subaortic stenosis in adults. Am J Cardiol. 1978;42:283-90.

Rholicek CV, del Pino SF, Hosking M, et al. Natural history and surgical outcomes for isolated discrete subarotic stenosis in children. Heart. 1999;82:708-13.

Wright GB, Kane JF, Nadas AS, et al. Fixed subaortic stenosis in the young: medical and surgical course in 83 patients. Am J Cardiol. 1983;52:830-5.

Hage FG, Zoghbi GJ, Aqel RA, Nanda NC. Subaortic stenosis missed by invasive hemodynamic assessment. Echocardiography. 2008;25(9):1007-10.


Butany J, Vaideeswar P, David TE. Discrete subaortic membranes in adults--a clinicopathological analysis. Cardiovasc Pathol. 2009;18(4):236-42.


Iwata Y, Imai Y, Shin'oka T, Kurosawa H. Subaortic stenosis associated with systolic anterior motion. Heart Vessels. 2008;23(6):436-9.


Wright GB, Keane JF, Nadas AS, Bernhard WF, Castaneda AR. Fixed subarotic stenosis in the young: medical and surgical course in 83 patients. Am J Cardiol. 1983;52:830 – 835.

Stassano P, Di Tommaso L, Contaldo A, et al: Discrete subaortic stenosis : Long-term prognosis and progression of the obstruction and of the aortic insufficiency. J Thorac Cardiovasc Surg. 2005;53:23 – 27.


Hardesty RL, Griffith BP, Mathews RA, et al. Discrete subvalvular aortic stenosis. An evaluation of operative therapy. J. Thorac Cradiovasc Surg. 1977;74:352–361.


How to Cite
Bejiqi R, Bejiqi H, Retkoceri R. Echocardiography as a Predicting Method in Diagnosis, Evaluation and Assessment of Children with Subvalvar Aortic Stenosis. Open Access Maced J Med Sci [Internet]. 2016Jan.20 [cited 2020Nov.25];4(1):74-8. Available from:
B - Clinical Sciences