山崎 嘉久¹, 田内 宣生¹, 長谷川 誠一¹, 村瀬 允也², 前田 正信², 冨田 康裕², 遠藤 斗紀雄³, 岩崎 浩康³, 牧 貴子⁴, 高井 正昭⁵, 松島 罩ｆ娃⁶, 奥村 直哉⁶

Yoshihisa YAMAZAKI¹, Nobuo TAUCHI¹, Seiichi HASEGAWA¹, Mitsuya MURASE², Masanobu MAEDA², Yasuhiro TOMIDA², Tokio ENDO³, Hiroyasu IWASAKI³, Takako MAKI⁴, Masaaki TAKAI⁵, Masaki MATSUSHIMA⁶, Naoya OKUMURA⁶

¹大垣市民病院小児循環器新生児科, ²大垣市民病院胸部外科, ³大垣市民病院放射線技術部, ⁴名城病院小児循環器科, ⁵名城病院中央検査部, ⁶中京病院小児循環器科

¹Department of Pediatric Cardiology and Neonatology, Ogaki Municipal Hospital, ²Department of Thoracic and Cardiovascular Surgery, Ogaki Municipal Hospital, ³Department of Radiology, Ogaki Municipal Hospital, ⁴Department of Pediatric Cardiology, Meijo Hospital, ⁵Department of Clinical Laboratory, Meijo Hospital, ⁶Department of Pediatric Cardiology, Chukyo Hospital

キーワード : Subaortic ridge, Ventricular septal defect, Discrete subaortic stenosis, Color flow mapping

We studied 8 patients with the subaortic ridge associated with ventricular septal defect (VSD) retrospectively. The type of VSD was perimembranous in 5 patients, subarterial in 2 and muscular in 1. Infundibular pulmonary stenosis (2), aortic regurgitation (2), pulmonary hypertension (2) and dextrocardia (1) were also associated problems. There was only one case in whom we could detect the ridge during the initial echocardiographic examination. In 7 cases the ridge was discovered through follow up examinations.
We confirmed the presence of a significant pressure gradient across the left ventricular outflow tract by catheterization in 3 cases who were older than 12 months, but no pressure gradients were detected m any patients less than 1 year old. In 5 of the 6 cases who underwent intracardiac repair, the ridge was not resected. A loud murmur remained in 2 patients and a pressure gradient in 3. Recently we resected the ridge in one patient with good results.
The clinical significance of a subaortic ridge with no pressure gradient is still unclear, although there is a potential for progression in some cases. Our current policy is to resect the ridge during surgical correction of the associated lesions and in the case of small VSD careful observations should be repeated using Doppler echocardiography.