RT Book, Section A1 Cohen, Jennifer A1 Ezon, David A1 Stern, Kenan A1 Zaidi, Ali N. A2 Fuster, Valentin A2 Narula, Jagat A2 Vaishnava, Prashant A2 Leon, Martin B. A2 Callans, David J. A2 Rumsfeld, John S. A2 Poppas, Athena SR Print(0) ID 1202452339 T1 Left Heart Obstructive Lesions T2 Fuster and Hurst's The Heart, 15e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781264257560 LK accessmedicine.mhmedical.com/content.aspx?aid=1202452339 RD 2024/10/15 AB Chapter SummaryThis chapter describes the presentation, diagnosis, and management of congenital left heart obstructive lesions, a series of anatomic stenotic lesions from the left atrium extending to the descending thoracic aorta (see Fuster and Hurst's Central Illustration). Obstruction may be in the left atrium, at the level of the aortic or mitral valve (subvalvar, valvar, or supravalvar), in the ascending aorta, transverse aortic arch, or in the descending thoracic aorta. These left heart obstructive lesions may present either in isolation or in association with other left-sided lesions. Based on their location, these lesions may cause impairment in valvular function (either aortic or mitral) or may impose increased afterload on the left ventricle and, if severe and untreated, may result in hypertrophy and dysfunction of the left ventricle. Cardiac imaging is essential for diagnosis, management, and long-term follow-up, and it increasingly plays a role in understanding the physiologic changes of left-sided obstructive lesions and the timing for intervention. Treatment is based on the underlying left heart obstructive lesion and may involve either transcatheter or directed surgical repair.