Overview
Subaortic stenosis is a narrowing of the left ventricular outflow tract just below the aortic valve. It can be congenital or acquired, and in rare cases, can be a complication following cardiac procedures.Diagnosis
Diagnosis is typically made via echocardiography, which can assess the severity of the stenosis and its location.
Cardiac catheterization may be used to confirm findings and assess pressure gradients.Management
Management depends on the severity of the stenosis and symptoms.
Options include medical management to control symptoms, surgical resection of the subaortic membrane, or balloon dilation.Special Populations
Patients on chronic steroid therapy undergoing transcatheter aortic valve replacement (TAVR) have a significantly higher risk of major vascular complications, including aortic annulus rupture 1.Key Recommendations
Patients on chronic steroid therapy undergoing TAVR have an increased risk of major vascular complications, including aortic annulus rupture 1. (Evidence: Moderate)
Consider the increased risk of vascular complications in patients on chronic steroid therapy when planning TAVR 1. (Evidence: Moderate)References
1 Ang SP, Chia JE, Jaiswal V, Hanif M, Vadhera A, Gautam S et al.. Vascular complications and outcomes following transcatheter aortic valve replacement in patients on chronic steroid therapy: a meta-analysis. International journal of surgery (London, England) 2024. link