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The Ross, Konno, and Ross–Konno operations for congenital left ventricular outflow tract abnormalities*

Published online by Cambridge University Press:  29 December 2014

Constantine Mavroudis ,
Constantine D. Mavroudis  and
Jeffrey P. Jacobs
Constantine Mavroudis*
Affiliation:
Johns Hopkins Children’s Heart Surgery, Florida Hospital for Children, Orlando, Florida, United States of America
Constantine D. Mavroudis
Affiliation:
Division of Cardiovascular Surgery, University of PennsylvaniaDepartment of Surgery, Philadelphia, Pennsylvania, United States of America
Jeffrey P. Jacobs
Affiliation:
Johns Hopkins Children’s Heart Surgery, All Children’s Hospital, St Petersburg, Florida, United States of America
*
Correspondence to: C. Mavroudis, MD, Johns Hopkins Children’s Heart Surgery, Florida Hospital for Children, 2501N Orange Ave, Suite 540, Orlando, FL 32804, United States of America. Tel: +407 303 3697; Fax: +407 303 3634; E-mail: Constantine.Mavroudis.MD@flhosp.org
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Abstract

Operations for left ventricular outflow tract abnormalities are centred on hemodynamic conditions that relate to subvalvar stenosis, valvar stenosis/regurgitation, aortic annular hypoplasia, and supravalvar aortic stenosis. Operative interventions over the years have evolved because the intervening outcomes proved to be unsatisfactory. The resection for subvalvar aortic stenosis has progressed from a fibrous “membrane” resection to a more extensive fibromuscular resection. Operative solutions for valvar aortic stenosis and regurgitation have resulted in operative interventions that depend on simple commissurotomy, leaflet extensions, prosthetic mechanical valve replacement, biologic valve replacement, including the pulmonary autograft, and operations to treat aortic annular stenosis. Although there are enthusiastic proponents for all of these strategies, the fact remains that none have proven to be curative; patients can expect to undergo further procedures during their lifetimes. The short- and mid-term solutions to these left ventricular outflow tract abnormalities have improved based on operations that have been attended by increasing operative complexity. The purpose of this review is to chronicle the operative steps of the Ross operation, the Konno–Rastan operation, the modified Konno operation, the Ross–Konno operation, and the modified Ross–Konno operation.

Keywords

CHDleft ventricular outflow tractsubvalvar stenosisvalvar stenosis/regurgitationaortic annular hypoplasiasupravalvar aortic stenosis
Type
Original Article
Information
Cardiology in the Young , Volume 24 , Issue 6: HeartWeek 2014 , December 2014 , pp. 1121 - 1133
Copyright
© Cambridge University Press 2014 

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Footnotes

*

Presented at All Children's Hospital Johns Hopkins Medicine 14th International Symposium on Congenital Heart Disease, Saint Petersburg, Florida, 15–18 February 2014, Special Focus: Diseases of the Cardiac Valves from the Fetus to the Adult, Co-Sponsor: The American Association for Thoracic Surgery (AATS).

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