Document Detail


Long-term results of the Konno procedure for complex left ventricular outflow tract obstruction.
MedLine Citation:
PMID:  17059924     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: This study was undertaken to determine long-term clinical and echocardiographic outcomes after the Konno procedure. METHODS: Fifty-three patients who underwent the Konno procedure between January 1, 1980, and January 1, 2004, were reviewed. RESULTS: Mean age at operation was 19 years (range, 1-65 years). Indications were as follows: complex subaortic or tunnel stenosis in 22 (41%), multilevel left ventricular outflow tract obstruction in 20 (38%), and aortic valve stenosis or hypoplasia in 11 (21%). Before the Konno procedure, 66 operations were performed in 41 (77%) patients. Thirty-three (62%) patients had greater than New York Heart Association class I symptoms preoperatively. A mechanical aortic valve was implanted in 40 (75%), a homograft in 10 (19%), and a xenograft prosthesis in 3 (6%). Mortality at 30 days was 8% (n = 4). Survival at 10 years was 86%. Risk factors for overall mortality were New York Heart Association class (hazard ratio 2.22, P = .04) and longer bypass time (hazard ratio 1.93/hour, P = .04). The cumulative probability of aortic valve reoperation was 19% at 5 years and 39% at 10 years, occurring in 15 patients at a median of 3.8 years. The average left ventricular outflow tract mean gradients were 19 mm Hg at 1 year (n = 9), 13 mm Hg at 1 to 3 years (n = 9), and 13 mm Hg at 3 to 5 years (n = 5). Pulmonary regurgitation was detected in 6 patients. Pulmonary valve replacement was performed in 3 (6%). At the date of last contact, all patients for whom data was available were in New York Heart Association functional class I or II. CONCLUSION: The Konno procedure is effective, allowing both long-term reduction of left ventricular outflow tract obstruction and improvement in functional class. Prosthetic aortic valve and native pulmonary valve complications may necessitate reoperation.
Authors:
Rakesh M Suri; Joseph A Dearani; Hartzell V Schaff; Gordon K Danielson; Francisco J Puga
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  132     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-10-24     Completed Date:  2006-11-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1064-71     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Surgery, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA. suri.rakesh@mayo.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Cardiac Surgical Procedures*
Child
Child, Preschool
Echocardiography
Female
Heart Valve Diseases / etiology
Heart Ventricles
Humans
Infant
Male
Middle Aged
Pulmonary Valve
Reoperation
Risk
Survival Analysis
Treatment Outcome
Ventricular Function, Left
Ventricular Outflow Obstruction / complications,  physiopathology,  surgery*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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