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Review
. 2025 Nov 27;27(1):164.
doi: 10.1007/s11886-025-02287-8.

Contemporary Review of Subaortic Stenosis Characteristics, Multi-modality Imaging and Management

Aro Daniela Arockiam  1 , Akiva Rosenzveig  1 , Sharmeen Sorathia  1 , Rishabh Khurana  1 , Ankit Agrawal  1 , Elio Haroun  1 , Rochell Issa  1 , Anoop Gurram  1 , Mohammad Alamer  1 , Tiffany Dong  1 , Joseph El Roumi  1 , Muhammad Majid  1 , Leonardo Rodriguez  1 , Zoran B Popovic  1 , Brian P Griffin  1 , Tom Kai Ming Wang  2
Affiliations
Review

Contemporary Review of Subaortic Stenosis Characteristics, Multi-modality Imaging and Management

Aro Daniela Arockiam et al. Curr Cardiol Rep. .

Abstract

Purpose of review: This review aims to provide a comprehensive contemporary overview regarding the clinical perspectives, multi-modality imaging evaluation, treatments and outcomes of subaortic stenosis (SAS).

Recent findings: SAS remains an important condition making up a significant minority of patients with progressive fixed left ventricular ouflow tract obstruction. Echocardiography remains the first-line imaging modality to diagnose SAS, evaluate severity of obstruction along with cardiac chamber and valvular function. Transesophageal echocardiography, cardiac computed tomography and cardiac magnetic resonance have adjunctive roles to help delineate SAS anatomy, functional implications and pre-operative planning. A variety of surgical techniques have been developed for SAS with significant obstruction often with symptoms, with excellent contemporary outcomes, though recurrence rates remain significant particularly in younger patients and those with complex anatomical features that may need repeat surgeries. Multi-disciplinary approach to management is necessary to improve clinical outcomes, including multi-modality imaging for diagnosis, risk stratification, treatment guidance and close surveillance, along with meticulous surgery by experienced surgeons, are necessary to improve clinical outcomes for SAS.

Keywords: Cardiac computed tomography; Cardiac magnetic resonance; Cardiac surgery; Congenital heart disease; Echocardiography; Subaortic stenosis.

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Conflict of interest statement

Declarations. Human and Animal Rights and Informed Consent: This article does not contain any studies with human or animal subjects performed by any of the authors. Competing Interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
(A) Subaortic membrane (arrow) visualized on 2D echocardiography. (B) Flow acceleration at the level of the membrane (C) Subaortic membrane (arrow) visualized on 2D echocardiography with continuous wave Doppler showing a fixed obstructive profile with peak velocity of 4.0 cm/s (D) mean gradient of 34mmHg (E) Transesophageal echocardiography showing a subaortic membrane (arrow) on 2D (F) Another patient transesophageal echocardiography showing subaortic membrane (arrow) with flow acceleration by color Doppler at the level of the membrane along with significant mitral regurgitation
Fig. 2
Fig. 2
Cardiac Magnetic Resonance Imaging, three chamber view showing subaortic membrane (A, yellow arrow) with dephasing jet across left ventricular outflow during left ventricular systole (B)
Fig. 3
Fig. 3
Computed Tomography Angiography Multiplanar Reconstruction Images (A-C) showing linear hypodensity (yellow arrows) in the left ventricular outflow suggesting subaortic membrane. D) Cinematic Volume Rendered Computed Tomography image showing subaortic membrane (black arrow)
See this image and copyright information in PMC

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