Long-term results after reconstruction of the left ventricular outflow tract by aortoventriculoplasty

Ullmann, Michael V.; Gorenflo, Matthias; Sebening, Christian; Lange, Rüdiger; Jakob, Heinz; Ulmer, Herbert E.; Hagl, S.

doi:10.1016/s0003-4975(02)04277-7

Cited by 7 publications

(17 citation statements)

References 22 publications

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“…It is the operations pioneered by Konno and Misbach and their respective colleagues, and by Rastan and Koncz, and then others, which provide specific relief for the tunnel variants. [185][186][187][188][189][190][191][192][193][194][195][196][197] The original Konno procedure did not spare the aortic valve, and indeed facilitated the positioning of an appropriately sized valvar prosthesis in the patient with a small aortic root. Variations of aortoventriculoplasty sparing the aortic valve were then introduced, leading eventually to the so-called Ross-Konno procedure.…”

Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

“…Variations of aortoventriculoplasty sparing the aortic valve were then introduced, leading eventually to the so-called Ross-Konno procedure. [188][189][190][191][192][193][194][195][196][197] These techniques are well summarized in the third edition of Cardiac Surgery as produced by Kirklin and Barratt-Boyes. 156 Surgical mortalities range from 5 to 15 percent.…”

Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

“…Others have now reported similar series. 156,163,194,195,197 Thus, using any of a variety of surgical techniques, very acceptable outcomes should now be anticipated for patients with long segment subaortic stenosis. Similar operative approaches have been reported in the dog, beginning with transventricular dilation, progressing through removal of the shelf and myomectomy, and also using conduits placed from the apex of the left ventricle to the aorta.…”

Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

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Thoughts about fixed subaortic stenosis in man and dog

et al. 2005

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T HE LESION PRODUCING THE TYPICALLY FIXED form of obstruction within the left ventricular outflow tract seemingly changes and evolves after birth. As we will discuss, patients exhibiting this characteristic exhibit some aspects of both acquired and congenital cardiac malformations. In these respects, canine subaortic stenosis is remarkably similar, especially as seen in the Newfoundland breed. Indeed, there is now a considerable literature devoted to subaortic stenosis in several mammalian species, including the cow and swine as well as the dog. 1-11 As far as the dog is concerned, the Newfoundland is but one of a number of breeds found to harbour the fascinating lesion that obstructs the left ventricular outflow tract. The lesion has also been found in boxers, rottweilers, golden retrievers, German shepherds, German shorthaired pointers, and Bouviers de Flandres. 6-11 In this review, we will discuss in detail this fixed type of subaortic stenosis as seen in the setting of an intact ventricular septum, addressing the underlying pathology, the evolving methodologies of investigation, and the results after surgical intervention. When germane, we will make comparisons with knowledge of subaortic stenosis as seen in the dog, particularly the Newfoundland. We have excluded from discussion, however, those patients with an atrioventricular septal defect in the setting of common atrioventricular junction. The Newfoundland breed The Newfoundland dog figures importantly in discussions about subaortic stenosis. The Newfoundland breed, 12,13 during the 19th century, became a status symbol for European society. Indeed, at one time this particular dog was the most popular canine import to Great Britain. The dogs themselves became instantly recognizable after Sir Edwin Landseer painted one of their numbers in 1838. The portrait was entitled "A Distinguished Member of the Humane Society" (Fig. 1). The dog in question was called Paul Pry, Landseer was paid £80 for his efforts, and the painting was eventually dedicated to the Royal Humane Society. 14,15 Historical perspective of subaortic stenosis It is the report of Norman C. Chevers, published in 1842, which is likely the earliest description of subaortic stenosis in man. 16 More than 80 years later,

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Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

Section: Evolutions In Therapeutic Modalitiesmentioning

confidence: 99%

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Thoughts about fixed subaortic stenosis in man and dog

et al. 2005

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“…1,2 In patients with valvular hypoplasia in combination with a tunnel-type subaortic stenosis, this procedure allows for a full and durable relief of the left ventricular outflow tract obstruction (LVOTO). [3][4][5][6] In the pediatric population, the use of a pulmonary valve autograft (Ross-Konno operation) instead of a mechanical valve has several advantages. 7,8 However, the Ross-Konno operation faces the probability of multiple reinterventions for graft failure in both aortic and pulmonary valve positions.…”

Section: Introductionmentioning

confidence: 99%

The Konno Operation Is a Durable Option for Relief of Aortic Stenosis in Patients With Complex Left Ventricular Outflow Tract Obstruction—A Single-Center 20-Year Experience

Matsushima

Burri

Strbad

et al. 2019

World J Pediatr Congenit Heart Surg

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Background:A Konno operation with a mechanical prosthesis may be applied in patients with complex left ventricular outflow tract obstruction to avoid further operations. We reviewed our 20-year experience with the Konno operation.Methods:All patients who underwent the Konno operation between 1996 and 2015 were evaluated. Study end points were survival and reoperations.Results:Twenty-one consecutive patients were included. The median age at operation was 12 years (5 months to 34 years). Twenty (95%) patients had prior interventions for left-sided heart lesions. Additional mitral valve disease was present in 17 (81%) patients. The preoperative mean pressure gradient over the left ventricular outflow tract was 50 ± 25 mm Hg. The median size of implanted valve prostheses was 21 mm (16-25 mm). Concomitant procedures for left-sided heart lesions were performed in six patients, including two mitral valve replacements. There were two hospital mortalities (9.5%) and four late mortalities (19%). Overall survival was 85% ± 7.8% and 72% ± 11% at 5 and 10 years, respectively. In two patients, mitral valve replacement was performed during the same hospital admission. During a mean follow-up time of 7.6 ± 4.8 years, two patients required late reoperations, one for mitral valve replacement and one for heart transplantation. Freedom from late reoperation at 10 years was 89% ± 7.4%.Conclusions:The Konno operation can be considered as a definitive option with a low probability of reoperation on the left ventricular outflow tract in patients with complex left ventricular heart disease. Subsequent operations focus on the treatment of additional mitral valve disease, which remains the cause of mortality and morbidity.

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“…Since Konno proposed this experimental method in 1970, numerous surgeons have employed this procedure widely [1 -6]. Results after aortoventriculoplasty are highly encouraging even in young infants [7,8]. A spectacular drop in the pressure gradient across the aortic valve after the surgery makes this procedure very attractive.…”

Section: Introductionmentioning

confidence: 99%