Your browser doesn't support javascript.
loading
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, Shunsuke; Burri, Melchior; Strbad, Martina; Ruf, Bettina; Lange, Rüdiger; Hörer, Jürgen; Cleuziou, Julie.
Afiliación
  • Matsushima S; Department of Cardiovascular Surgery, German Heart Center Munich, Technical University of Munich, School of Medicine, Munich, Germany.
  • Burri M; Department of Cardiovascular Surgery, German Heart Center Munich, Technical University of Munich, School of Medicine, Munich, Germany.
  • Strbad M; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany.
  • Ruf B; Department of Congenital and Paediatric Heart Surgery, German Heart Center Munich, Technical University of Munich, School of Medicine, Munich, Germany.
  • Lange R; Department of Pediatric Cardiology and Congenital Heart Disease, German Heart Center Munich, Technical University of Munich, School of Medicine, Munich, Germany.
  • Hörer J; Department of Cardiovascular Surgery, German Heart Center Munich, Technical University of Munich, School of Medicine, Munich, Germany.
  • Cleuziou J; Insure (Institute for Translational Cardiac Surgery), Department of Cardiovascular Surgery, German Heart Center Munich, Munich, Germany.
World J Pediatr Congenit Heart Surg ; 10(6): 678-685, 2019 11.
Article en En | MEDLINE | ID: mdl-31701836
ABSTRACT

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.
Asunto(s)
Palabras clave

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Obstrucción del Flujo Ventricular Externo / Predicción / Procedimientos Quirúrgicos Cardíacos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: World J Pediatr Congenit Heart Surg Año: 2019 Tipo del documento: Article País de afiliación: Alemania

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Obstrucción del Flujo Ventricular Externo / Predicción / Procedimientos Quirúrgicos Cardíacos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Child / Child, preschool / Female / Humans / Infant / Male Idioma: En Revista: World J Pediatr Congenit Heart Surg Año: 2019 Tipo del documento: Article País de afiliación: Alemania