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Ross-Konno operation in children.

Viktor Hraska1, Joachim Photiadis, Rudolf Poruban

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The Ross-Konno procedure offers a durable solution for complex left ventricular outflow tract obstruction in infants. This surgical technique provides a better alternative to repeated interventions, improving outcomes for neonates with critical aortic stenosis.

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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.