Ross-Konno procedure in neonates: report of three patients

Lacour-Gayet, François; Sauer, H; Ntalakoura, Kalliopi; Müller, Andreas; Rázek, Vít; Weil, Jochen; Haun, Christoph

doi:10.1016/s0003-4975(03)01279-7

Cited by 22 publications

(9 citation statements)

References 8 publications

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“…Previous reports emphasizing outcomes in the neonatal or infant population have cited various risk factors for mortality-younger age, associated arch or mitral valve disease, emergency presentation with severe aortic insufficiency after balloon dilatation, duration of cardiopulmonary bypass and/or myocardial ischemia, postoperative mechanical circulatory support, and suitability for biventricular repair. [1][2][3]5,6,14,15,17,[21][22][23] Although risk factor analysis was not a primary objective of our study because of the nature of the database, we did observe higher mortality in neonates in comparison with infants. Mortality was also higher in patients who had concomitant arch repair or received postoperative mechanical circulatory support.…”

Section: Commentmentioning

confidence: 65%

“…2 Numerous other reports describe individual center's experiences with 1 or more technique of AVR in the pediatric age group, but offer little information specific to neonates or infants. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] Contemporary benchmark data based on a larger multicenter cohort of neonates and infants undergoing AVR could potentially improve our understanding of outcomes in this challenging group of patients. We therefore sought to describe characteristics and outcomes for neonates and infants undergoing AVR across a large multi-institutional cohort using the Society of Thoracic Surgeons (STS) Congenital Heart Surgery Database.…”

mentioning

confidence: 99%

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Aortic valve replacement in neonates and infants: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Woods

Pasquali

Jacobs

et al. 2012

The Journal of Thoracic and Cardiovascular Surgery

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Section: Commentmentioning

confidence: 65%

mentioning

confidence: 99%

Aortic valve replacement in neonates and infants: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Woods

Pasquali

Jacobs

et al. 2012

The Journal of Thoracic and Cardiovascular Surgery

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“…Other surgical options available in neonates with critical aortic stenosis, like the Ross or Ross-Konno procedures, have not be taken in consideration in the above multi-institutional study, despite previous positive reports [19][20][21][22][23]. In fact the above study could not better recommend the Ross-Konno procedure for neonates with critical aortic stenosis.…”

Section: Aortic Valve Stenosismentioning

confidence: 93%

Borderline left ventricle

Corno

2005

European Journal of Cardio-Thoracic Surgery

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The first problem to solve when dealing with the topic 'borderline left ventricle' is to find the appropriate definition. Several parameters have been taken into consideration, either morphometric (diameter of the mitral valve, indexed mitral valve area, left ventricular inflow dimension, left ventricular cross-sectional area, ratio between the apex-to-base left ventricular dimension and right ventricular dimension, left ventricular long axis to heart long axis ratio, left ventricular end diastolic volume, left ventricular mass index, ratio of the right/left ventricular wall thickness, presence of endocardial fibroelastosis, cardiac apex not formed by the left ventricle, diameter of the ventriculo-aortic junction, diameter of the aortic valve annulus and indexed aortic root diameter) as well as functional (left ventricular ejection fraction, left ventricular end diastolic pressure, mean pulmonary artery pressure, direction of the blood flow in the ascending aorta and at the level of the patent ductus arteriosus). Pre-operative determination whether the left ventricle is adequate to sustain the systemic circulation, or it may became adequate with the available surgical approaches, and therefore a bi-ventricular type of repair is feasible, can be extremely difficult, particularly in the presence of a 'borderline left ventricle'. In the clinical practice pediatric cardiologists and cardiac surgeons are faced with the problem of the 'borderline left ventricle' in four different groups of congenital heart defects: (a) aortic valve stenosis, (b) aortic coarctation, with or without hypoplastic aortic arch, (c) hypoplastic left heart complex, (d) right ventricular pressure and/or volume overload. In all the above situations in the presence of a left ventricle smaller than normal a very exhaustive approach has been reviewed in the decision making process, taking in account the literature reports as well as the personal experience. In each patient with 'borderline left ventricle' the elements to be considered for the decision making process between uni- and bi-ventricular type of repair, or for less ideal options of management, are the following: morphometric and functional parameters, hemodynamic data, available surgical options, results of the personal and institutional experience.

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“…1,2 The operation is suitable for neonates or infants with critical aortic stenosis who show unacceptable results following open or balloon valvotomy. [1][2][3]9 Some newborns with critical aortic stenosis, a hypoplastic aortic annulus (<5 mm), and significant EFE can be effectively treated by the primary Ross-Konno procedure and resection of EFE, thus avoiding single ventricular palliation. The Ross-Konno procedure allows easy access to the left ventricular cavity for resection of EFE, normalizing the LVOT and the long axis of the left ventricle.…”

Section: Advantagesmentioning

confidence: 99%

“…1,2,5 The Ross-Konno procedure is applicable in patients with an interrupted aortic arch as the initial procedure or after primary repair in patients with a severely restricted subaortic area, hypoplastic aortic annulus, and bicuspid valve. 6,9 Decreasing Mortality and Morbidity. Estimated risk of in-hospital mortality is close to 10%.…”

Section: Advantagesmentioning

confidence: 99%

Ross-Konno Procedure in Children: Midterm Results

Hraška

Lilje

Kantorova³

et al. 2010

World J Pediatr Congenit Heart Surg

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The aim of this study was to analyze the midterm results following the Ross-Konno procedure in children. Between 1999 and 2008, 29 patients with complex left ventricular outflow tract obstruction underwent the Ross-Konno procedure. There were 12 (41%) infants (group A) and 17 (59%) older patients (group B). The median age at operation was 3.3 years (range, 6 days to 16 years). At 7 years of follow-up, survival was 96% (1 late death), with no differences between groups A and B. Freedom from aortic regurgitation ≥ mild was 81%, with no differences between groups A and B. No residual gradient was noted in the left ventricular outflow tract in either group. Freedom from mitral regurgitation ≥ mild was 100% in group B and 41% in group A (P = .0029). The mitral regurgitation was associated with morphological abnormalities of the mitral valve and with development of endocardial fibroelastosis after failed intervention during the newborn period. Freedom from reoperation was 73% in group B and 24% in group A (P = .0093). All patients are now in sinus rhythm, and 43% are without medication. With the technical aspects of this procedure well accomplished, mortality is low, and the functional outcome is encouraging. At midterm follow-up, there was no residual or recurrent outflow tract obstruction and an excellent function of the neoaortic valve. The higher incidence of mitral regurgitation in infants, which was associated with morphological abnormalities of mitral valve and development of endocardial fibroelastosis, is worrisome.

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Ross-Konno procedure in neonates: report of three patients

Cited by 22 publications

References 8 publications

Aortic valve replacement in neonates and infants: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Aortic valve replacement in neonates and infants: An analysis of the Society of Thoracic Surgeons Congenital Heart Surgery Database

Borderline left ventricle

Ross-Konno Procedure in Children: Midterm Results

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