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The Ross, Konno, and Ross-Konno operations for congenital left ventricular outflow tract abnormalities

Constantine Mavroudis1, Constantine D Mavroudis2, Jeffrey P Jacobs3

  • 11Johns Hopkins Children's Heart Surgery,Florida Hospital for Children,Orlando,Florida,United States of America.

Cardiology in the Young
|February 4, 2015
PubMed

Insights

Surgical approaches for left ventricular outflow tract abnormalities have evolved due to unsatisfactory outcomes. This review details complex operations like the Ross and Konno procedures for these conditions.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Left ventricular outflow tract abnormalities encompass subvalvar stenosis, valvar stenosis/regurgitation, and aortic annular/supravalvar stenosis.
  • Past surgical interventions have shown limitations, necessitating ongoing advancements in operative techniques.
  • Patient outcomes historically required re-interventions, highlighting the need for improved surgical solutions.

Purpose of the Study:

  • To review and detail the surgical steps of specific complex operations for left ventricular outflow tract abnormalities.
  • To provide a historical perspective on the evolution of surgical techniques for these conditions.
  • To discuss the operative nuances of the Ross, Konno-Rastan, modified Konno, Ross-Konno, and modified Ross-Konno operations.

Main Methods:

  • Literature review focusing on surgical techniques for left ventricular outflow tract abnormalities.
  • Chronological analysis of operative interventions and their evolution.
  • Detailed description of the surgical steps for the Ross, Konno-Rastan, and modified Konno procedures, including hybrid approaches.

Main Results:

  • Surgical strategies have progressed from simple resections to more complex procedures.
  • Various techniques exist for valvar aortic stenosis and regurgitation, including commissurotomy, leaflet extensions, and valve replacements (mechanical, biologic, pulmonary autograft).
  • Despite improvements, current operations are not curative, and re-interventions are often necessary.

Conclusions:

  • The evolution of surgical techniques for left ventricular outflow tract abnormalities reflects a continuous effort to improve patient outcomes.
  • Complex operations like the Ross and Konno procedures represent significant advancements in managing these challenging conditions.
  • Further research and refinement of these surgical strategies are essential to achieve more definitive solutions.

Keywords:
supravalvar aortic stenosis

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