DISCRETE SUBAORTIC VALVULAR STENOSIS - THE CLINICAL UTILITY AND LIMITATIONS OF TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Transesophageal echocardiography (TEE) is a useful technique in the di agnosis and intraoperative assessment of discrete subaortic stenosis ( DSS). It allows clear visualization of the subaortic membrane, which m ay be missed by transthoracic echocardiography, differentiates DSS fro m other causes of left ventricular outflow tract obstruction, and accu rately detects the presence of associated aortic regurgitation and bac terial endocarditis. Limitations in its use include inadequate visuali zation of the left ventricular outflow tract by TEE in the presence of a prosthetic mitral valve or mitral annular calcification, and improp er alignment of the Doppler cursor across the outflow tract.