Aortoventriculoplasty with the pulmonary autograft: The "Ross-Konno" procedure

Abstract

Initial experience suggests that aortoventriculoplasty with the pulmonary autograft is an excellent alternative for young patients with complex left ventricular outflow tract obstruction. Because the pulmonary autograft has been shown to grow after implantation, reoperation on the left ventricular outflow tract is likely to be avoided.

Defining the Efficacy of Aortic Root Enlargement Procedures: A Comparative Analysis of Surgical Techniques

“…This procedure has been most commonly performed in conjunction with a pulmonary homograft in a pediatric or young adult population for the treatment of congenital aortic stenosis 24 and more recently for the treatment of complex left ventricular outflow tract obstruction, especially in those with a small aortic root. 25 Aortoventriculoplasty is technically demanding, requiring patch closure of both the interventricular septum and the right ventricle and care must be taken to avoid injury to the first septal perforating artery and the conduction system.…”

Long-term results after reconstruction of the left ventricular outflow tract by aortoventriculoplasty

“…In the presence of complex LVOTO, AVR alone will not sufficiently resolve the underlying problem, even when AVR is performed in combination with posterior aortic root enlargement, as described by Manouguian and Seybold-Epting [15]. Subaortic stenosis with longsegmented, "tunnel-like" obstruction requires an adequate enlargement of the subvalvular region, as provided by the Konno procedure and the Ross-Konno procedure [16]. The Konno procedure can be used to treat all levels of aortic stenosis.…”

Autotransplante da valva pulmonar na posição aórtica (cirurgia de Ross)

“…Basicamente, a experiência desses autores, apesar de limitada, revela baixo índice de complicações a curto prazo e re-Autotransplante da valva pulmonar na posição aórtica Arq Bras Cardiol volume 70, (nº 5), 1998 sultados favoráveis, considerando o procedimento como ideal para troca valvar em crianças e adultos jovens. As formas mais graves de obstrução (complexas) podem ser tratadas através da associação de técnicas como a recentemente proposta aortoventriculoplastia (cirurgia de Ross-Kono) 32 , havendo inclusive relato de sua realização em neonatos com fibroelastose endocárdica 33 . Uma experiência interessante é a relatada por Kouchoukos e col 29 : 33 pacientes operados entre 1989-93 (implantação da valva e tronco pulmonar como unidade): usando ecocardiograma intra-operatório para medir diâmetros valvar aórtico e pulmonar e também no pós-operatório, para avaliar a função da neovalva aórtica, esses autores relataram ausência de mortalidade hospitalar, enfatizando a segurança da técnica.…”