The American journal of cardiology
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The late results were evaluated of operations for the relief of left ventricular outflow tract obstruction in young patients, 1 to 18 years old, from the National Heart Institute who were followed up for at least 5 years and from recently reported studies with an average follow-up duration of 5 or more years. The operative mortality rate for the combined series was low: 1.9 percent of 522 patients with valvular aortic stenosis, 6.0 percent of 222 patients with fixed subvalvular aortic stenosis and 5.5 percent of 18 patients with hypertrophic subaortic stenosis. From the National Heart Institute series, gradients early postoperatively were decreased to less than 50 mm Hg in 88 percent (30 of 34) of patients with valvular, in 68 percent (15 of 22) of patients with subvalvular and in 88 percent (8 of 9) of patients with hypertrophic subaortic stenosis. ⋯ Of the patients having unsatisfactory late results, major hemodynamic abnormalities were detected in 55 percent (23 of 42) within 1 year postoperatively. Thus it appears that operations for many children with left ventricular outflow tract obstruction are palliative. These patients should have early postoperative assessment and continuing long-term follow-up evaluation during childhood, adolescence and adulthood.