A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring

Konno, S; Imai, Yasuharu; Iida, Yoshinao; Nakajima, Masamichi; Tatsuno, Katsuhiko

doi:10.1016/s0022-5223(19)39673-4

Cited by 456 publications

(113 citation statements)

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“…The use of prosthetic mesh is avoided by modifying the various incisions so that they can be closed primarily without patching the left ventricular outflow tract. They feel this aortoseptal modification may be the procedure of choice for diffuse stenosis limited to the subvalvular area and that aortoventriculoplasty as described by Konno et al, 19 Misbach et al,20 and Rastan and colleagues21 22 is still applicable for tunnel lesions which also have involvement of valvular or supravalvular levels. Recently, Vouhe and Neveux17 reported that the anatomic features of the subvalvular aortic stenosis will determine their choice of surgical intervention: transaortic resection of the subvalvular membrane is used for localized discrete lesions and aortoventriculoplasty is used for diffuse lesions with preservation of the native aortic valve whenever possible.…”

Section: Resultsmentioning

confidence: 94%

Transaortic Resection of the Subaortic Membrane

Jacobs

Palatianos

Cintron

et al. 1994

Chest

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Section: Resultsmentioning

confidence: 94%

Transaortic Resection of the Subaortic Membrane

Jacobs

Palatianos

Cintron

et al. 1994

Chest

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“…Short-term studies have demonstrated favor-able results in some patients after dual-chamber pacing. [8][9][10][11][12][13][14]15 However, hemodynamic deterioration has occurred in patients in whom the LVOT gradient increased and the pulmonary artery pressure increased with resultant decrease in cardiac output. In nearly all patients, diastolic function deteriorated and left atrial pressure increased; the long-term implications of these findings are unknown.…”

Section: Discussionmentioning

confidence: 99%

Operative Treatment of Hypertrophic Obstructive Cardiomyopathy and Aortic Valve Disease in Infants

Son¹,

Hambsch²,

Bossert³

et al. 1985

Echocardiography

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Background: The indications for operative intervention for symptomatic hypertrophic obstructive cardiomyopathy (HOCM) in infancy and childhood are not well defined because of the rarity of the lesion. The traditional surgical procedure consists of septal myectomy. In an attempt to further improve the outcome of HOCM associated with concentric left ventricular hypertrophy and aortic valve disease in infancy, we have combined resection of the left ventricular septum and free wall with a Ross‐Konno procedure. Methods: Three infants (aged 3, 4, and 10 months) with HOCM (left ventricular aortic gradients of 75, 95, and 110 mmHg), associated concentric left ventricular hypertrophy, and valvar aortic stenosis (n = 1) or combined valvar aortic stenosis and regurgitation (n = 2) underwent extensive resection of fibroelastosis and subendocardial myocardium of the left ventricular septum and free wall in combination with a Ross‐Konno operation. All three patients had marked systolic anterior motion of the mitral valve. The length of the incision into the ventricular septum was 1.8, 2.0, and 2.3 cm. Results: In all three patients this procedure resulted in a marked reduction of width of the left ventricular septum (median 9 mm vs 14 mm preoperatively) and the left ventricular posterior free wall (median 8 mm vs 12 mm preoperatively) and an almost twofold increase of the left ventricular end‐diastolic volume (median 13.5 cm3 vs 7.0 cm3 preoperatively). The neo‐aortic valve functioned normally. Systolic anterior motion of the anterior leaflet of the mitral valve had completely resolved in two patients and had markedly regressed in the remaining patient. At follow‐up of 15, 17, and 26 months, two patients had absence of a left ventricular outflow tract gradient and the third patient had a residual sub‐valvar gradient of 15 mmHg. Conclusions: The reported procedure may be a valuable technique in severe forms of hypertrophic cardiomyopathy associated with aortic valve disease. The operation results in enlargement of the left ventricular stroke volume and improvement of the left ventricular diastolic function, restores aortic valve anatomy and function, and abolishes or decreases systolic anterior motion of the mitral valve. (J Card Surg 1999:14:273–278)

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“…Tunnel type SAS often necessitates extensive myomyectomy or application of the Konno-Rastan procedure to reconstruct the LVOT. 6 Repair of the AV may be necessary if moderate or severe AR is present. The recurrence rate of SAS following surgical repair is highest in the tunnel type lesions (37%) and less common in discrete lesions (15%), preoperative resting Doppler peak gradient >40 mmHg and immediate postoperative gradient >10 mmHg identify a subset of patients that are at increased risk of SAS recurrence.…”

Section: Subaortic Stenosismentioning

confidence: 99%

Echocardiographic Evaluation of Congenital Left Ventricular Outflow Obstruction

Aboulhosn

Child

2014

Echocardiography

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Left ventricular outflow obstructions (LVOTO) encompass a series of stenotic lesions beginning within the anatomic left ventricular outflow tract and ending in the descending thoracic aorta, occurring alone or in series. The degree of stenosis and hemodynamic consequences may vary from mild and well tolerated to severe and functionally limiting. The majority of LVOTO (with the exception of calcific and rheumatic aortic stenosis) are congenital in etiology. Echocardiography has become an integral tool in the assessment of patients with congenital heart disease. This article is a contemporary review of the clinical features of LVOTO and the role of echocardiography in this patient population.

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A new method for prosthetic valve replacement in congenital aortic stenosis associated with hypoplasia of the aortic valve ring

Cited by 456 publications

References 1 publication

Transaortic Resection of the Subaortic Membrane

Transaortic Resection of the Subaortic Membrane

Operative Treatment of Hypertrophic Obstructive Cardiomyopathy and Aortic Valve Disease in Infants

Echocardiographic Evaluation of Congenital Left Ventricular Outflow Obstruction

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