ROENTGENOGRAPHIC ASPECTS OF CONGENITAL LEFT VENTRICULAR OUTFLOW TRACT OBSTRUCTION

¹ From the Department of Radiology, The Ohio State UniVersity Hospitals, Columbus, Ohio.
² From the Department of Medicine, The Ohio State UniVersity Hospitals, Columbus, Ohio.
³ From the Department of Thoracic Surgery, The Ohio State UniVersity Hospitals, Columbus, Ohio.

Twenty-eight cases of congenital left ventricular outflow tract obstruction have been analyzed with particular attention to the roentgenographic findings. The diagnostic criteria both on plain roentgenograms and on angiograms are described and evaluated, and illustrative cases are presented.

The diagnostic criteria for subvalvular aortic stenosis include: enlargement and hypertrophy of the left ventricle, presence of a subvalvular membrane and an extra chamber; usually, a normal aortic valve.

Subvalvular idiopathic muscular hypertrophy represents a subgroup of lesions in this location and may cause stenosis.

Congenital valvular aortic stenosis is characterized by thickening, poor flexibility, or doming of the valve with a clear jet seen frequently; poststenotic dilatation of the aorta is typical. A subgroup is represented by those with an associated small aortic valve annulus. The left ventricle is usually hypertrophied but there is not much over-all cardiac enlargement.

The supravalvular aortic stenoses usually show a markedly hypertrophied left ventricle, a normal aortic valve or some involvement of its upper part, a supravalvular constriction of the aorta, and a small ascending aorta.

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