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Right Ventricular Outflow Conduit Stenosis After Childhood Ross-Konno Procedure
Lakshmi Kattamuri1, Kunal Sharma1, Kahtan Fadah2
1Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, Texas, USA.
Background:
Right ventricle-pulmonary artery (RV-PA) conduit stenosis is a relatively uncommon complication after a childhood Ross-Konno procedure.
Case Summary:
A man in his 20s presented with progressive dyspnea for 1 year. He had previously undergone modified Konno and Ross-Konno procedures for congenital subaortic stenosis followed by pulmonic balloon valvuloplasty for RV-PA stenosis. Echocardiography demonstrated reduced left ventricular ejection fraction, severe pulmonary hypertension, and right ventricular outflow tract obstruction. Cardiac computed tomography revealed right ventricular outflow/conduit stenosis with calcification. Right heart catheterization showed elevated right ventricular outflow/conduit pressure gradient, confirming severe conduit stenosis. He was referred for surgical pulmonic valve and conduit repair.
Discussion:
Surgical conduit replacement remains the most definitive treatment strategy in small, calcified conduits. Multimodal imaging strategies aid in comprehensive assessment of anatomy and function of RV-PA conduit and valves to guide intervention strategies in adults with complex congenital heart disease.
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