KONNO Procedure Aortoventriculoplasty in Children with Left Ventricular Outflow Tract Obstruction

Abstract

Over the past 20 years, mortality from the Konno-Rastan operation using mechanical valves has declined from 25% to approximately 10%.[41] For older children, the mortality ranges from 4.7% to 8.3%.[42,44] The Ross-Konno procedure carries a lower mortality rate, whether this is because of more recent experience with this technique or due to the fact that homograft implantation results in lower postoperative LVOT gradients needs to be determined.[41, 68,83] The Konno procedure is often considered as a final available option after initial attempts with “less invasive” catheter-based or surgical techniques fail to relieve complex LVOTO. This data suggest that the Konno procedure should be used earlier in patients with less symptomatic disease, especially those in whom an expeditious procedure can be carried out to relieve aortic valve pathology in conjunction with tunnel subaortic obstruction. Clinical and echocardiographic surveillance after surgery is important to detect aortic and pulmonary valve complications during long-term follow-up.