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The Natural History of Mild Congenital Aortic Stenosis in Patients Studied by Serial Left Heart Catheterization.

Lawrence Sanford Cohen, M.D.; Eugene Braunwald, M.D., F.A.C.P.; John Ross Jr., M.D., F.A.C.P.; and Andrew G. Morrow, M.D., F.A.C.P.
Ann Intern Med. 1968;68(5):1152-1153. doi:10.7326/0003-4819-68-5-1152_4
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An important unanswered question concerning the natural history of congenital aortic stenosis is whether mild obstruction in asymptomatic children progresses to severe obstruction in later life. Eighteen patients with congenital aortic stenosis found to have mild to moderate obstruction at left heart catheterization when first studied between 1957 and 1962 were recalled for study in 1967. One patient had died suddenly. In six patients a significant increase in the degree of obstruction to left ventricular outflow was found, that is, the left ventricular-aortic gradient increased by more than 30 mm Hg, or the outflow orifice area declined to below 0.6

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