Conclusions. The modified Konno-Rastan procedure represents an excellent therapy for diffuse or unresectable SAS in patients with a normal aortic valve. Asian Cardiovasc Thorac Ann. Oct;14(5) Classic Konno-Rastan procedure: indications and results in the current era. Tabatabaie MB(1), Ghavidel . Ann Thorac Surg. May;65(5); discussion Modified Konno- Rastan procedure for subaortic stenosis: indications, operative techniques, and.
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The aortic valve is replaced with either a mechanical valve Konno-Rastan Procedurean aortic homograft human aortic valveor with the patient’s own pulmonary valve. The development of a new systolic murmur or the intensification of a soft murmur is an indication that the LVOT should be investigated through echocardiography.
The aortic valve itself also needs to be monitored to guard against progressive aortic insufficiency. Eleven patients had undergone previous procedures and 5 underwent the modified Konno-Rastan procedure as their primary operation. The modified Konno-Rastan procedure represents an excellent therapy for diffuse or unresectable SAS in patients with a normal aortic valve. There was 1 late postoperative death caused by pneumonia 2 years after operation 6.
Diffuse or unresectable subaortic stenosis SAS necessitates an aggressive surgical approach for the elimination of left ventricular outflow tract obstruction. When their function becomes impaired for any of these reasons, replacement becomes necessary.
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Aortic Stenosis – Konno Procedure This procedure is performed in cases of Aortic Stenosis when the left ventricular outflow tract is stenotic in addition to the aortic valve itself. After the Konno Procedure, the possibility of renewed narrowing of the left ventricular outflow tract LVOT exists and the patient will need regular monitoring.
Although it usually is performed through a transventricular approach, the modified Konno-Rastan procedure also can be performed through a transatrial approach; this is particularly useful in patients rxstan have had previous ventricular septal defect closure associated with SAS occurring proximal to the prosthetic patch.
In the last case, the valve may grow and renew itself over time. This page is available in: In addition, it produces excellent results in a limited number of patients with hypertrophic obstructive cardiomyopathy, in whom the Morrow procedure traditionally has been performed.
Most surgically implanted rastaan valves will last years before they wear out, become obstructed, or lose efficiency. One patient underwent a successful redo modified Konno-Rastan procedure 7 years after the first operation for residual left ventricular outflow tract obstruction immediately below the aortic valve. It involves the replacement of the aortic valve and the widening of the ventricular septum in the region of the valve with a patch see illustration.
Valve and Conduit Replacements. If this becomes significant, reoperation will be necessary.
Classic Konno-Rastan procedure: indications and results in the current era.
However, the first two types of replacement valve will eventually need to be replaced as the function over time decreases. One patient is awaiting reoperation for aortic incompetence unrelated to conal enlargement 1. However, significant aortic insufficiency is uncommon in the adult patient and mild insufficiency is well-tolerated and generally remains stable for long periods.
In this article we report our experience with the modified Konno-Rastan procedure, with inherent preservation of the native aortic valve and annulus, in the treatment of diffuse or unresectable SAS.