SURGICAL REPAIR OF PULMONARY STENOSIS WITH INTACT VENTRICULAR SEPTUM IN A 68-YEAR-OLD WOMAN

Patients with mild pulmonary stenosis after infarcy rarely have sympto ms or develop increasing obstruction. We experienced a 68-year-old wom an with severe pulmonary valvar and infundibular stenosis (peak to pea k pressure gradient=80 mmHg). She had been pointed out heart disease a t the age of six. Endocarditis at the age of 17 might induce calcifica tion of valve and affect the progression of pulmonary stenosis, and mo reover, which might gradually develop severe subvalvar obstruction and poststenotic aneurysm of pulmonary trunk. She refused operative inter vention because of mild clinical symptoms (NYHA class II), but we reco mmended surgical repair due to repeated transient ischemic attacks, wh ich were suspected paradoxical embolism through persistent foramen ova le. She underwent pulmonary valvotomy and infundibular resection and i s doing well.