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You are here: Contents > 2017 > Volume 26 Number 2 March 2017 > CASE REPORTS > Severe Valvular Aortic Stenosis and Fixed Subvalvular Aortic Stenosis: A Rare and Challenging Combination

Severe Valvular Aortic Stenosis and Fixed Subvalvular Aortic Stenosis: A Rare and Challenging Combination

Ayman Elbadawi1,5, Marwan Saad2, Islam Y. Elgendy3, Basarat Baig1, Farhad Abtahian4

1Department of Internal Medicine, Rochester General Hospital, Rochester, NY, USA
2Division of Cardiovascular Medicine, Department of Medicine, University of Arkansas for Medical Sciences, Little Rock AR, USA
3Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, USA
5Electronic correspondence: Ayman.Elbadawi@rochesterregional.org

A 58-year-old man with a history of hypertension presented with accelerating angina. Transthoracic echocardiography revealed a thickened aortic valve with pressure gradients and an estimated aortic valve area suggestive of mild aortic stenosis. Left heart catheterization demonstrated non-significant coronary artery disease. Pressure tracings showed a high left ventricular pressure and a mean gradient across the aortic valve of 69 mmHg. Subsequent transesophageal echocardiography revealed a subvalvular aortic stenosis that was secondary to the subaortic membrane, with severe valvular aortic stenosis. The patient underwent surgical resection of the subaortic membrane followed by bioprosthetic aortic valve replacement, with resolution of his symptoms.


Video 1: Transesophageal echocardiography, five-chamber view, showing the calcified aortic valve and subaortic membrane.

Video 2: Transesophageal echocardiography, long-axis view, showing aliasing of the aortic flow at valvular and subvalvular levels.

The Journal of Heart Valve Disease 2017;26:240-242


Severe Valvular Aortic Stenosis and Fixed Subvalvular Aortic Stenosis: A Rare and Challenging Combination

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