Ross-Konno operation in children

Area of Science:

• Cardiovascular Surgery
• Pediatric Cardiology
• Congenital Heart Disease

Background:

• Complex multilevel left ventricular outflow tract obstruction (LVOTO) with severe annular hypoplasia and dysplastic aortic valve presents significant challenges.
• Current treatments may involve repeated interventions with limited long-term success and potential negative impact on ventricular function.
• Neonates and infants with critical aortic stenosis often have poor outcomes with traditional open or balloon valvotomy.

Purpose of the Study:

• To evaluate the efficacy and long-term durability of the Ross-Konno procedure for complex multilevel LVOTO in pediatric patients.
• To assess the Ross-Konno procedure as an alternative to reinterventions and less effective valvotomy techniques.
• To highlight the benefits of early surgical intervention using the Ross-Konno procedure.

Main Methods:

• The Ross-Konno procedure, involving aortic valve replacement with a pulmonary autograft and concomitant VSD closure/resection.
• Surgical technique applied to neonates and infants with complex multilevel LVOTO.
• Assessment of outcomes including reintervention rates, graft durability, and valve function.

Main Results:

• The pulmonary autograft shows excellent durability, with a low incidence of stenosis or dilatation.
• Low rates of aortic insufficiency were observed with the pulmonary autograft.
• The procedure avoids the need for repeated surgical reinterventions, offering a potentially permanent solution.

Conclusions:

• The Ross-Konno procedure is a highly effective treatment for complex multilevel LVOTO in newborns and infants.
• It provides a durable alternative to other interventions, improving long-term outcomes.
• This technique expands therapeutic options for neonates with critical aortic stenosis, offering superior results compared to traditional valvotomy.