A rare case of "subcommissural adhesive aortic stenosis": Triangular struggle of aortic valve area, hemodynamics, and calcium burden

Echocardiography. 2017 Nov;34(11):1717-1720. doi: 10.1111/echo.13729. Epub 2017 Oct 27.

Abstract

This report concerns an 83-year-old woman with aortic stenosis (AS) who had a history of repetitive hospitalization due to decompensated heart failure. Although her clinical history was compatible with significant AS, findings for aortic valve area, hemodynamics, and valvular calcium burden were discrepant. Multiplanar reconstruction images revealed the membranous structures attached to a subcommissural lesion, which resulted in severe stenosis. The patient had a favorable clinical course after transcatheter aortic valve replacement. This is the first reported case of severe AS due to the subcommissural adhesions, which were successfully visualized by means of echocardiography and computed tomography.

Keywords: aortic stenosis; multidetector-row computed tomography; multiplanar reconstruction image; subcommissural adhesion; three-dimensional echocardiography.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aortic Valve / diagnostic imaging
  • Aortic Valve / physiopathology
  • Aortic Valve / surgery
  • Aortic Valve Stenosis / complications*
  • Aortic Valve Stenosis / diagnostic imaging*
  • Aortic Valve Stenosis / physiopathology
  • Aortic Valve Stenosis / surgery
  • Calcinosis / complications*
  • Echocardiography, Transesophageal / methods*
  • Female
  • Heart Valve Prosthesis
  • Hemodynamics*
  • Humans
  • Multidetector Computed Tomography / methods
  • Transcatheter Aortic Valve Replacement / methods*
  • Treatment Outcome