[Konno's operation for residual aortic stenosis following Nick's operation--a case report]

A 43-year-old woman successfully underwent the Konno's operation as a reoperative procedure for residual aortic stenosis following the Nicks' operation. The patient had had congenital valvular and subvalvular aortic stenosis and a patent ductus arteriosus previously divided. At age 33, she had undergone the Nicks' operation (posterior ring enlargement) and aortic valve replacement with a 19 mm Bicer valve prosthesis 9 years 6 months prior to the reoperation. The preoperative left ventricular-aortic pressure gradient was 120 mmHg which decreased but remained about 60 mmHg after the Nicks' procedure. The patient again developed heart failure and frequent episodes of atrial fibrillation which required repeated hospital admissions. Approximately 10 years following the original procedure, the Konno's operation (anterior ring enlargement) was performed using a 23 mm St. Judes Medical aortic prosthesis to manage residual aortic stenosis. The postoperative course was uneventful and the left ventricular-aortic pressure gradient reduced to 16 mmHg. We conclude that the Konno's operation can be safely performed for residual aortic stenosis following the Nicks' operation.