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Published on: June 20, 2018
Ross-Konno procedure in infants: mid-term results
Pauline Aszyk1, Christian Thiel, Nicodème Sinzobahamvya
1German Pediatric Heart Centre, Asklepios Clinic Sankt Augustin, Sankt Augustin, Germany.
Summary
The Ross-Konno procedure shows promising mid-term results for infant left ventricular outflow tract obstruction, with excellent neoaortic valve function and high survival rates. However, early morbidity and reoperation rates due to conduit failure require attention.
Area of Science:
- Pediatric Cardiac Surgery
- Congenital Heart Disease
- Cardiovascular Surgery
Background:
- Complex left ventricular outflow tract (LVOT) obstruction in infants presents significant surgical challenges.
- The Ross-Konno procedure is a complex reconstructive technique for LVOT obstruction.
Purpose of the Study:
- To evaluate the mid-term outcomes of the Ross-Konno procedure in a cohort of infants.
- To assess survival, functional results, and complications associated with this procedure.
Main Methods:
- A retrospective analysis of 16 infants (including 5 newborns) who underwent the Ross-Konno procedure between 2000 and 2011.
- Detailed assessment of concomitant procedures, including mitral valve surgery, endocardial fibroelastosis resection, and aortic arch reconstruction.
- Evaluation of mid-term follow-up data including survival, valve function, and reoperation rates.
Main Results:
- Actuarial survival was 93.3% at 5 years, with one late death.
- Excellent neoaortic valve function was observed, with no residual or recurrent LVOT obstruction at mid-term follow-up.
- Significant early postoperative morbidity was noted, and freedom from mitral regurgitation or mitral valve replacement was 70%.
Conclusions:
- The Ross-Konno procedure, when technically well-executed, offers encouraging functional outcomes and minimal surgical risk in infants.
- Early postoperative morbidity and a high reoperation rate due to conduit failure are significant concerns.
- Concomitant mitral valve surgery does not increase mortality, and early intervention for endocardial fibroelastosis may preserve mitral valve function.
