My son is going to be having his second Subaortic membrane resection next month. His first OHS was at 22 months and was necessary due to significant aortic leak and moderate peak gradient of 48. Turned out the ring shaped membrane was fused to the aortic valve. Post-op he had a trivial aortic leak and gradient of 10.
We have been closely monitoring his echo gradient ever since:
Peak gradient results summary (mmHg)
1 month post op - 10
2 months post op - 17
8 months post op - 39
14 months post op - 45
19 months post op - 49 (referred by our cardiologist for second opinion Echo)
21 months post op - 65 (Valsalva peak measuring 80 + significant LVH)
I know it is possible and not uncommon for this condition to recur, but we are just blown away by how quickly it has grown back. We are going back to our surgeon who did first operation (Ucla) and are very worried about risk of heart block. Presently his AR is trivial, so at least that is working in our favor this time. My concern is about how high his Valsalva gradient is right now. His surgery will be in four weeks (doctors said we could wait until his 4 year old birthday party). It only took him rolling on his side and grimacing to achieve the gradient of 80. He is a active, asymptomatic 4 year old, should we be limiting his activity and level/quantity of physical exertion until surgery? I am sure he will self-regulate to some extent, but with the significant LVH we are worried that exertion could somehow be fatal or cause more damage in some way?
Have you heard of cases of the membrane growing back this aggressively?
Thank you for your advice.