Mitral Disease: The Real Burden for Ross-Konno Procedure in Children

Vergnat, Mathieu; Roubertie, François; Lambert, Virginie; Laux, Daniéla; Ly, Mohamed; Roussin, Régine; Baruteau, Alban‐Elouen; Capderou, André; Kalfa, David; Belli, Emrè

doi:10.1016/j.athoracsur.2014.06.063

Cited by 13 publications

(17 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[11][12][13][14] Re-interventions include arch re-operation, left ventricle outflow repair, and mitral valve replacement. [13][14][15][16] Moreover, conversion to a single ventricle strategy for "failed" biventricular repair is associated with significant morbidity and mortality. 14…”

Section: Aetiology Of Left Ventricle Hypoplasiamentioning

confidence: 99%

“…with mortality. 16 Morbidity included multiple re-operations on the mitral valve and pulmonary hypertension. Others have used selection criteria that focus on mitral valve disease in determining whether a biventricular repair should be attempted.…”

Section: Mitral Valve Diseasementioning

confidence: 99%

“…The major morbidities associated with biventricular repair include multiple re-interventions and pulmonary hypertension 11 – 14 . Re-interventions include arch re-operation, left ventricle outflow repair, and mitral valve replacement 13 – 16 . Moreover, conversion to a single ventricle strategy for “failed” biventricular repair is associated with significant morbidity and mortality 14 …”

Section: Aetiology Of Left Ventricle Hypoplasiamentioning

confidence: 99%

See 2 more Smart Citations

Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use?

Kaplinski

Cohen

2015

Cardiol Young

View full text Add to dashboard Cite

Borderline left ventricle refers to a spectrum of left ventricular underdevelopment, typically associated with other cardiac anomalies. The left ventricle may be mildly hypoplastic, as is sometimes seen accompanying aortic coarctation, or it can be severely hypoplastic, as is seen in hypoplastic left heart syndrome. For patients with a borderline left ventricle that is at either extreme, the treatment decision is relatively straightforward. Those with the most severe form of left ventricle hypoplasia will require single ventricle palliation or cardiac transplantation, whereas those with the mildest form may not need any intervention. It is the management strategy of children that fall within the grey zone of the spectrum, which continues to be controversial and remains variable within and among different institutions. Cardiac diseases with associated left ventricle hypoplasia include critical aortic stenosis, mitral stenosis, coarctation of the aorta, arch hypoplasia, cor triatriatum, unbalanced common atrioventricular canal, Shone's complex, total anomalous pulmonary venous return, and complex conotruncal abnormalities. In this review, we will discuss the assessment and management of infants with borderline left ventricle with critical aortic stenosis or arch obstruction and associated mitral anomalies.

show abstract

Section: Aetiology Of Left Ventricle Hypoplasiamentioning

confidence: 99%

Section: Mitral Valve Diseasementioning

confidence: 99%

Section: Aetiology Of Left Ventricle Hypoplasiamentioning

confidence: 99%

See 1 more Smart Citation

Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use?

Kaplinski

Cohen

2015

Cardiol Young

View full text Add to dashboard Cite

show abstract

“…[8][9][10] Moreover, patients with complex LVOTO often have additional mitral valve disease such as valve dysplasia, in which the Ross-Konno operation puts three valves at risk for postoperative complication. [10][11][12] It is well known that patients with complex LVOTO frequently require multiple interventions. 5,12 In these patients, the Konno operation with a mechanical prosthesis may provide a definitive option, avoiding further operations on the left ventricular outflow tract (LVOT).…”

Section: Introductionmentioning

confidence: 99%

The Konno Operation Is a Durable Option for Relief of Aortic Stenosis in Patients With Complex Left Ventricular Outflow Tract Obstruction—A Single-Center 20-Year Experience

Matsushima

Burri

Strbad

et al. 2019

World J Pediatr Congenit Heart Surg

View full text Add to dashboard Cite

Background:A Konno operation with a mechanical prosthesis may be applied in patients with complex left ventricular outflow tract obstruction to avoid further operations. We reviewed our 20-year experience with the Konno operation.Methods:All patients who underwent the Konno operation between 1996 and 2015 were evaluated. Study end points were survival and reoperations.Results:Twenty-one consecutive patients were included. The median age at operation was 12 years (5 months to 34 years). Twenty (95%) patients had prior interventions for left-sided heart lesions. Additional mitral valve disease was present in 17 (81%) patients. The preoperative mean pressure gradient over the left ventricular outflow tract was 50 ± 25 mm Hg. The median size of implanted valve prostheses was 21 mm (16-25 mm). Concomitant procedures for left-sided heart lesions were performed in six patients, including two mitral valve replacements. There were two hospital mortalities (9.5%) and four late mortalities (19%). Overall survival was 85% ± 7.8% and 72% ± 11% at 5 and 10 years, respectively. In two patients, mitral valve replacement was performed during the same hospital admission. During a mean follow-up time of 7.6 ± 4.8 years, two patients required late reoperations, one for mitral valve replacement and one for heart transplantation. Freedom from late reoperation at 10 years was 89% ± 7.4%.Conclusions:The Konno operation can be considered as a definitive option with a low probability of reoperation on the left ventricular outflow tract in patients with complex left ventricular heart disease. Subsequent operations focus on the treatment of additional mitral valve disease, which remains the cause of mortality and morbidity.

show abstract

“…The main risk factors are need for concomitant mitral valve surgery and preoperative left ventricular dysfunction. 1 Although the Ross-Konno procedure is a treatment of choice in infants with a combination of aortic stenosis and left ventricular outflow tract obstruction, mitral valve surgery is still controversial especially in small weight patients, where the option of valve replacement is very limited. We describe a successful case of the Ross-Konno procedure, combined with a mitral valve replacement with a novel type of handmade bioprosthesis in a 49-day-old 3.4-kg infant.…”

Section: Introductionmentioning

confidence: 99%

Ross-Konno Procedure With Cylinder Mitral Valve Replacement in 49 Days Old Infant

Fedevych¹,

Yachnik²,

Mykychak³

et al. 2017

World J Pediatr Congenit Heart Surg

View full text Add to dashboard Cite

A neonate with antenatally diagnosed severe aortic valve stenosis, left ventricular outflow tract obstruction, left ventricular endocardial fibroelastosis, and severe mixed mitral valve disease was admitted to our center for balloon aortic valvuloplasty. On day 49, we performed a Ross-Konno procedure and mitral valve replacement on the baby, whose weight was 3.4 kg. Right ventricle-to-pulmonary artery continuity was restored with a handmade trileaflet Gore-Tex conduit. We used a handmade cylindrical prosthesis made from decellularized equine pericardium in the mitral position. We observed improvement in left ventricular function and good performance of aortic, pulmonary, and mitral prostheses at four months of follow-up.

show abstract

Mitral Disease: The Real Burden for Ross-Konno Procedure in Children

Cited by 13 publications

References 21 publications

Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use?

Characterising adequacy or inadequacy of the borderline left ventricle: what tools can we use?

The Konno Operation Is a Durable Option for Relief of Aortic Stenosis in Patients With Complex Left Ventricular Outflow Tract Obstruction—A Single-Center 20-Year Experience

Ross-Konno Procedure With Cylinder Mitral Valve Replacement in 49 Days Old Infant

Contact Info

Product

Resources

About