Impact of Konno Procedure on Right Heart Function

The Konno procedure, a left-sided surgical intervention, can lead to right-sided heart failure postoperatively due to pulmonary or tricuspid valve dysfunction.

A 62-year-old woman with prior mechanical aortic and mitral valve replacements underwent a Konno procedure. She later presented with severe right heart failure and was found to have right ventricular enlargement, mitral patient-prosthesis mismatch, an iatrogenic ventricular septal defect, and severe pulmonic and tricuspid regurgitation.

At even the most experienced centers, Konno is associated with up to 16% significant pulmonary valve disruption. Timely recognition and management of complications of procedures like the Konno will become more important with the increasing complexity of patients undergoing invasive management.

Identification and successful management of complications after complex surgical procedures require careful evaluation, and a high index of suspicion tailored to the surgical approach. Furthermore, these complex patients may benefit from contemporary advances in transcatheter valve technology.