subarotic memmbrane

[om2001]

Last physical check up, my 12 year old son diagnosed with a subarotic memmbrane. He does not have any syndrome except heart murmur. He is normal kid playing basket ball, running, biking, swimming ….
As per doctor advice we did echo test. Echo test conclusion given below:
5 mm subarotic membrane 7 mm from aortic annulus , with mild subaortic stenosis (peak gradient 20 mm Hg)
Mild aortic reguragition.
Normal LV size and systolic fuction.
Doctor said open heart surgery required to stop future more aortic valve leak. Base on his echo report, when we should go for the surgery or we will wait and monitor? A concerned parents …any answer means lot to us…..

[Marie M Gleason, M.D.]

Subaortic membranes are pieces of fibrous tissue that arise in the outflow tract of the left side of the heart.  The turbulent blood flow hitting the aortic valve can damage the aortic valve and thicken the edges, causing the aortic valve to leak.  The amount of blockage out of the heart can be variable and these membranes often progress over time.  Your son's level of blockage seems mild, but he does have mild aortic valve leakage. At our institution we would not generally operate so early, given that the aortic valve leakage is mild and we have no prior data to see if it is changing.  The drivers for surgery are either worsening of the obstruction or a changing amount of aortic valve leakage.  I would recommend a follow up echo in 6 months and then a decision can be made as to whether there is enough going on to warrant the risk of surgery. In addition, you should know that ~ 15% of these membranes can grow back after surgery.  

[om2001]

Thank you.. thank you very much for your kind response.