HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Misbach, G. A. Articles by Ebert, P. A. Search for Related Content PubMed PubMed Citation Articles by Misbach, G. A. Articles by Ebert, P. A.

The Journal of Thoracic and Cardiovascular Surgery, Vol 84, 696-703, Copyright © 1982 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Left ventricular outflow enlargement by the Konno procedure

GA Misbach, K Turley, DJ Ullyot and PA Ebert

The optimal management of patients with small aortic anulus or left ventricular outflow tract obstruction remains unclear. Between 1976 and March, 1982; 18 patients have undergone enlargement of their left ventricular outflow tract by means of the Konno or a modification of the Konno procedure. Fourteen of these 18 patients had previous operations for aortic stenosis or tunnel left ventricular outflow tract, and two patients had undergone three previous operations. All 18 patients had symptoms of either heart failure of chest pain, or had electrocardiographic evidence of strain. They ranged in age from 4 years to 58 years, with 13 of the 18 patients being less than 20 years of age. A Dacron patch was used to enlarge the left ventricular outflow tract after incising down the ventricular septum. In all patients, at least a 21 mm valve could be placed, with between 50% and 65% of the valve anulus being made up of natural tissue. The remaining portion of the valve anulus was constructed from the Dacron patch. The patch was extended up to enlarge the ascending aorta, and a pericardial patch was used to close the defect in the right ventricular outflow tract. In all 18 patients the gradient was obliterated at the time of operation. There was one early death in a patient who had previous insertion of a left ventricular apical-aortic conduit in which the heterograft valve had degenerated. There has been one late death because of bacterial endocarditis in a child who also had a parachute mitral valve and evidence of pulmonary hypertension. The remaining 16 patients are functioning well after the Konno procedure. Three are receiving warfarin sodium, and 13 are receiving aspirin. These results suggest that this is an acceptable method of treating patients with small aortic anulus or left ventricular outflow tract obstructions and would appear to have advantages over a left ventricular apical-aortic conduit.

This article has been cited by other articles:

				Y. Kobayashi, Y. Fukushima, T. Hayase, K. Kojima, and G. Endo Clinical Outcome of Aortic Valve Replacement With 16-mm ATS-Advanced Performance Valve for Small Aortic Annulus Ann. Thorac. Surg., April 1, 2010; 89(4): 1195 - 1199. [Abstract] [Full Text] [PDF]

				R. M. Suri, J. A. Dearani, H. V. Schaff, G. K. Danielson, and F. J. Puga Long-term results of the Konno procedure for complex left ventricular outflow tract obstruction. J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1064 - 1071. [Abstract] [Full Text] [PDF]

				G. K. Sharma, M. Wojtalik, A. Siwinska, B. Mrozinski, M. Pawelec-Wojtalik, R. Bartkowski, W. Mrawczynski, and O. Trojnarska Aortoventriculoplasty and left ventricle function: long-term follow-up Eur J Cardiothorac Surg, July 1, 2004; 26(1): 129 - 136. [Abstract] [Full Text] [PDF]

				M. V. Ullmann, M. Gorenflo, C. Sebening, R. Lange, H. G. Jakob, H. E. Ulmer, and S. Hagl Long-term results after reconstruction of the left ventricular outflow tract by aortoventriculoplasty Ann. Thorac. Surg., January 1, 2003; 75(1): 143 - 146. [Abstract] [Full Text] [PDF]

				A. Gowdamarajan, D. M. Cohen, D. G. Rowland, J. T. Davis, and G. M. Schauer Valve sparing operation in a child with aneurysmal disease of the ascending aorta Ann. Thorac. Surg., April 1, 1999; 67(4): 1151 - 1152. [Abstract] [Full Text] [PDF]

				W. J. Daenen, M. A. Vanhove, and M. H. Gewillig Extended aortic root replacement with pulmonary autografts: Experience in 14 cases Ann. Thorac. Surg., August 1, 1995; 60(suppl_2): S180 - S184. [Abstract] [PDF]

				D. B. Ross, G. A. Trusler, J. G. Coles, I. M. Rebeyka, J. Smallhorn, W. G. Williams, and R. M. Freedom Small aortic root in childhood: Surgical options Ann. Thorac. Surg., December 1, 1994; 58(6): 1617 - 1624. [Abstract] [PDF]

				R. A. Jonas, Boston, Mass., J. M. Quaegebeur, N. York, N.Y., J. W. Kirklin, E. H. Blackstone, Birmingham, Ala., et al. Outcomes in patients with interrupted aortic arch and ventricular septal defectA multiinstitutional study J. Thorac. Cardiovasc. Surg., April 1, 1994; 107(4): 1099 - 1113. [Abstract] [Full Text]

				P. Kallis, J. F. Sneddon, I. A. Simpson, A. Fung, J. R. Pepper, and E. E. John Smith Clinical and hemodynamic evaluation of the 19-mm Carpentier-Edwards supraannular aortic valve Ann. Thorac. Surg., December 1, 1992; 54(6): 1182 - 1185. [Abstract] [PDF]

				P. R. Vouhe and J.-Y. Neveux Surgical management of diffuse subaortic stenosis: An integrated approach Ann. Thorac. Surg., September 1, 1991; 52(3): 654 - 661. [Abstract] [PDF]

				J. R. Stewart, W. H. Merrill, J. W. Hammon Jr, T. P. Graham Jr, and H. W. Bender Jr Reappraisal of localized resection for subvalvar aortic stenosis Ann. Thorac. Surg., August 1, 1990; 50(2): 197 - 203. [Abstract] [PDF]

				S. F. Bolling, M. D. Iannettoni, M. Dick II, A. Rosenthal, and E. L. Bove Shone's anomaly: Operative results and late outcome Ann. Thorac. Surg., June 1, 1990; 49(6): 887 - 893. [Abstract] [PDF]

				S. Y. DeLeon, M. N. Ilbawi, R. A. Arcilla, O. G. Thilenius, J. A. Quinones, E. C. Duffy, and R. F. Sulayman Transatrial relief of diffuse subaortic stenosis after ventricular septal defect closure Ann. Thorac. Surg., March 1, 1990; 49(3): 429 - 434. [Abstract] [PDF]

				D. A. Cooley and J. R. Garrett Septoplasty for Left Ventricular Outflow Obstruction without Aortic Valve Replacement: A New Technique Ann. Thorac. Surg., October 1, 1986; 42(4): 445 - 448. [Abstract] [PDF]

				R. G. Johnson, G. R. Williams, J. D. Razook, W. M. Thompson, M. M. Lane, and R. C. Elkins Reoperation in Congenital Aortic Stenosis Ann. Thorac. Surg., August 1, 1985; 40(2): 156 - 162. [Abstract] [PDF]

				T. E. Kersten, F. B. Bessinger, F. M. Stone, and D. M. Nicoloff Combined Techniques for Double Valve Replacement in the Infant Ann. Thorac. Surg., February 1, 1985; 39(2): 180 - 184. [Abstract] [PDF]

				G. A. Misbach, K. Turley, and P. A. Ebert Pulmonary Valve Replacement for Regurgitation after Repair of Tetralogy of Fallot Ann. Thorac. Surg., December 1, 1983; 36(6): 684 - 691. [Abstract] [PDF]

				T. E. David and D. E. Uden Aortic Valve Replacement in Adult Patients with Small Aortic Annuli Ann. Thorac. Surg., November 1, 1983; 36(5): 577 - 583. [Abstract] [PDF]