Surgical Correction of Congenital Aortic and Pulmonary Stenosis in an Adult

Abstract

Although aortic and pulmonary valve stenosis are among the most common congenital heart defects, the combination of both aortic and pulmonary valve stenosis in the same patient appears to be very uncommon. Accurate diagnosis of combined valvular stenosis is imperative prior to surgical correction otherwise surgery of only one of the lesions may result in an insufficient hemodynamic improvement. A 34-year-old man with congenital aortic and pulmonary valve stenosis underwent Nick's operation, aortic valve replacement, pulmonary valvotomy and resection of anomalous muscle of the right ventricular outflow tract. The operation was successfully performed and postoperative course was uneventful.

Keywords

• Aortic valve stenosis; pulmonary valve stenosis; ventricular outflow obstruction;adult; congenital.

Erişkinde Konjenital Aort ve Pulmoner Stenozu Cerrahi Onarımı

Abstract

Aort ve pulmoner kapak darlığı en sık görülen konjenital kalp anomalileri olmasına rağmen aynı hastada kombine olarak görülmesi nadir görülen bir durumdur. Mevcut lezyonların sadece birisine cerrahi uygulaması, hemodinamik düzelmenin yetersiz kalmasıyla sonuçlanabileceğinden, cerrahi onarımı öncesi kombine valvular stenozun kesin tanısının konulması zorunludur. Konjenital aort darlığı ile seyreden pulmoner stenozu olan 34 yaşında erkek hastaya Nick operasyonu, aort kapak replasmanı, pulmoner valvutomi ve sağ ventrikül çıkım yolundaki anormal kas bandı rezeksiyonu uygulandı. Ameliyat başarıyla gerçekleşmiş olup, ameliyat sonrası dönemi sorunsuz seyretti.

Keywords

• Aort kapak darlığı; pulmoner kapak darlığı; ventrikül çıkım engeli; yetişkin;konjenital.

References

1. Beard EF, Cooley DA, Latson JR. Combined congenital subaortic stenosis and infundibular subpulmonic stenosis. Arch Intern Med 1957;100:647-50.
2. Shemin RJ, Kent KM, Roberts W. Syndrome of valvular pulmonary stenosis and valvular aortic stenosis with atrial septal defect. Br Heart J 1979;42:442-6.
3. Milazzo AS, Golioto A, Camitta MG, O’Laughlin MP. An infant with subvalvar aortic stenosis, subvalvar and valvar pulmonary steno- sis, severe biventricular hypertrophy and pulmonary hemorrhage. Pediatr Cardiol 2003;24:169-71.
4. Jacob R. Morgan. Combined aortic and pulmonic valvular stenosis with an ostium primum atrial septal defect. Chest 1972;61:510-2.
5. Neufeld HN, Ongley PA, Edwards JE. Combined congenital su- baortic stenosis and pulmonary infundibular stenosis. Br Heart J 1960;22:686-90.
6. Horlick L, Merriman JE. Congenital valvular stenosis of pulmonary and aortic valves with atrial septal defect. Am Heart J 1957;54:615- 20.
7. Kelly DT. Congenital stenosis of pulmonary and aortic valves. Am J Cardiol 1965;16:750-3.
8. Sissman NJ, Neill CA, Spencer FC, Taussig HB. Congenital aortic stenosis. Circulation 1959;19:458-68.

9. Tokel K. Interventional therapy in valvular aortic stenosis and val- vular peripheral pulmonary stenosis. Turkiye Klinikleri J Cardiol- Special Topics 2008;1:116-26.
10. Cruz E, Billieux MH, Beghetti M. A neonate with isolated combined aortic and pulmonary valvar stenosis. Int J Cardiol 2007;116:13- 14.