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Subaortic ventricular septal bulge

MedGen UID:
1671018
•Concept ID:
C4732781
•
Anatomical Abnormality
HPO: HP:0031971

Definition

A localized hypertrophy of the subaortic segment of the ventricular septum has been frequently described in elderly persons, and variously termed subaortic ventricular septal bulge (VSB), sigmoid-shaped septum, localized or discrete upper septal hypertrophy. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSubaortic ventricular septal bulge

Conditions with this feature

Hypertrophic cardiomyopathy 11
MedGen UID:
436962
•Concept ID:
C2677506
•
Disease or Syndrome
An autosomal dominant subtype of familial hypertrophic cardiomyopathy caused by mutation(s) in the ACTC1 gene, encoding actin, alpha cardiac muscle 1.
See: Condition Record
Hypertrophic cardiomyopathy 11

Recent clinical studies

Etiology

Prevalence, clinical correlates, and functional impact of subaortic ventricular septal bulge (from the Baltimore Longitudinal Study of Aging).
Canepa M, Malti O, David M, AlGhatrif M, Strait JB, Ameri P, Brunelli C, Lakatta EG, Ferrucci L, Abraham TP
Am J Cardiol 2014 Sep 1;114(5):796-802. Epub 2014 Jun 19 doi: 10.1016/j.amjcard.2014.05.068. PMID: 25129067Free PMC Article
Bulging subaortic septum: an important risk factor for systolic anterior motion after mitral valve repair.
Said SM, Schaff HV, Suri RM, Greason KL, Dearani JA, Nishimura RA
Ann Thorac Surg 2011 May;91(5):1427-32. Epub 2011 Apr 2 doi: 10.1016/j.athoracsur.2011.01.084. PMID: 21459359
Transcoronary ablation of septal hypertrophy (TASH): a new treatment option for hypertrophic obstructive cardiomyopathy.
Kuhn H, Gietzen FH, Leuner C, Schäfers M, Schober O, Strunk-Müller C, Obergassel L, Freick M, Gockel B, Lieder F, Raute-Kreinsen U
Z Kardiol 2000;89 Suppl 4:IV41-54. doi: 10.1007/s003920070062. PMID: 10810776
Subaortic septal bulge simulates hypertrophic cardiomyopathy by angulation of the septum with age, independent of focal hypertrophy. An echocardiographic study.
Krasnow N
J Am Soc Echocardiogr 1997 Jun;10(5):545-55. doi: 10.1016/s0894-7317(97)70009-9. PMID: 9203495
An echocardiographic study of localized subaortic hypertrophy.
Shapiro LM, Howat AP, Crean PA, Westgate CJ
Eur Heart J 1986 Feb;7(2):127-32. doi: 10.1093/oxfordjournals.eurheartj.a062034. PMID: 2938953

Diagnosis

Bulging subaortic septum: an important risk factor for systolic anterior motion after mitral valve repair.
Said SM, Schaff HV, Suri RM, Greason KL, Dearani JA, Nishimura RA
Ann Thorac Surg 2011 May;91(5):1427-32. Epub 2011 Apr 2 doi: 10.1016/j.athoracsur.2011.01.084. PMID: 21459359
Transcoronary ablation of septal hypertrophy (TASH): a new treatment option for hypertrophic obstructive cardiomyopathy.
Kuhn H, Gietzen FH, Leuner C, Schäfers M, Schober O, Strunk-Müller C, Obergassel L, Freick M, Gockel B, Lieder F, Raute-Kreinsen U
Z Kardiol 2000;89 Suppl 4:IV41-54. doi: 10.1007/s003920070062. PMID: 10810776
Subaortic septal bulge simulates hypertrophic cardiomyopathy by angulation of the septum with age, independent of focal hypertrophy. An echocardiographic study.
Krasnow N
J Am Soc Echocardiogr 1997 Jun;10(5):545-55. doi: 10.1016/s0894-7317(97)70009-9. PMID: 9203495
Clinical and morphologic expression of hypertrophic cardiomyopathy in patients > or = 65 years of age.
Lewis JF, Maron BJ
Am J Cardiol 1994 Jun 1;73(15):1105-11. doi: 10.1016/0002-9149(94)90291-7. PMID: 8198038
An echocardiographic study of localized subaortic hypertrophy.
Shapiro LM, Howat AP, Crean PA, Westgate CJ
Eur Heart J 1986 Feb;7(2):127-32. doi: 10.1093/oxfordjournals.eurheartj.a062034. PMID: 2938953

Therapy

Prevalence, clinical correlates, and functional impact of subaortic ventricular septal bulge (from the Baltimore Longitudinal Study of Aging).
Canepa M, Malti O, David M, AlGhatrif M, Strait JB, Ameri P, Brunelli C, Lakatta EG, Ferrucci L, Abraham TP
Am J Cardiol 2014 Sep 1;114(5):796-802. Epub 2014 Jun 19 doi: 10.1016/j.amjcard.2014.05.068. PMID: 25129067Free PMC Article
Bulging subaortic septum: an important risk factor for systolic anterior motion after mitral valve repair.
Said SM, Schaff HV, Suri RM, Greason KL, Dearani JA, Nishimura RA
Ann Thorac Surg 2011 May;91(5):1427-32. Epub 2011 Apr 2 doi: 10.1016/j.athoracsur.2011.01.084. PMID: 21459359
Endocardial radiofrequency ablation of septal hypertrophy. A new catheter-based modality of gradient reduction in hypertrophic obstructive cardiomyopathy.
Lawrenz T, Kuhn H
Z Kardiol 2004 Jun;93(6):493-9. doi: 10.1007/s00392-004-0097-x. PMID: 15252744
Post-mitral valve repair systolic anterior motion produced by non-obstructive septal bulge.
Civelek A, Szalay Z, Roth M, Arnold R, Klövekorn WP, Vogt PR, Bauer EP
Eur J Cardiothorac Surg 2003 Dec;24(6):857-61. doi: 10.1016/s1010-7940(03)00571-2. PMID: 14643800
Transcoronary ablation of septal hypertrophy (TASH): a new treatment option for hypertrophic obstructive cardiomyopathy.
Kuhn H, Gietzen FH, Leuner C, Schäfers M, Schober O, Strunk-Müller C, Obergassel L, Freick M, Gockel B, Lieder F, Raute-Kreinsen U
Z Kardiol 2000;89 Suppl 4:IV41-54. doi: 10.1007/s003920070062. PMID: 10810776

Prognosis

Prevalence, clinical correlates, and functional impact of subaortic ventricular septal bulge (from the Baltimore Longitudinal Study of Aging).
Canepa M, Malti O, David M, AlGhatrif M, Strait JB, Ameri P, Brunelli C, Lakatta EG, Ferrucci L, Abraham TP
Am J Cardiol 2014 Sep 1;114(5):796-802. Epub 2014 Jun 19 doi: 10.1016/j.amjcard.2014.05.068. PMID: 25129067Free PMC Article
Bulging subaortic septum: an important risk factor for systolic anterior motion after mitral valve repair.
Said SM, Schaff HV, Suri RM, Greason KL, Dearani JA, Nishimura RA
Ann Thorac Surg 2011 May;91(5):1427-32. Epub 2011 Apr 2 doi: 10.1016/j.athoracsur.2011.01.084. PMID: 21459359
Post-mitral valve repair systolic anterior motion produced by non-obstructive septal bulge.
Civelek A, Szalay Z, Roth M, Arnold R, Klövekorn WP, Vogt PR, Bauer EP
Eur J Cardiothorac Surg 2003 Dec;24(6):857-61. doi: 10.1016/s1010-7940(03)00571-2. PMID: 14643800
Transcoronary ablation of septal hypertrophy (TASH): a new treatment option for hypertrophic obstructive cardiomyopathy.
Kuhn H, Gietzen FH, Leuner C, Schäfers M, Schober O, Strunk-Müller C, Obergassel L, Freick M, Gockel B, Lieder F, Raute-Kreinsen U
Z Kardiol 2000;89 Suppl 4:IV41-54. doi: 10.1007/s003920070062. PMID: 10810776

Clinical prediction guides

Systolic anterior motion of mitral valve following resection of subaortic membrane and intracardiac repair of tetralogy of fallot.
Gourav KP, Kumar B, Bhat I, Mishra AK
Ann Card Anaesth 2020 Jul-Sep;23(3):357-360. doi: 10.4103/aca.ACA_194_18. PMID: 32687100Free PMC Article
Bulging subaortic septum: an important risk factor for systolic anterior motion after mitral valve repair.
Said SM, Schaff HV, Suri RM, Greason KL, Dearani JA, Nishimura RA
Ann Thorac Surg 2011 May;91(5):1427-32. Epub 2011 Apr 2 doi: 10.1016/j.athoracsur.2011.01.084. PMID: 21459359
Endocardial radiofrequency ablation of septal hypertrophy. A new catheter-based modality of gradient reduction in hypertrophic obstructive cardiomyopathy.
Lawrenz T, Kuhn H
Z Kardiol 2004 Jun;93(6):493-9. doi: 10.1007/s00392-004-0097-x. PMID: 15252744
Disease of the left ventricle in pulmonary atresia with intact ventricular septum. The limiting factor for long-lasting successful surgical intervention?
Akiba T, Becker AE
J Thorac Cardiovasc Surg 1994 Jul;108(1):1-8. PMID: 8028353

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