Objective
Patient-prosthesis mismatch is often considered as an important cause of adverse outcome
following aortic valve replacement. A small annulus represents a challenge for the
surgeon; yet can be best managed at the initial operation using relatively simple
techniques, as later-on correction is often far more challenging. Corrective reoperations
necessitate drastic root enlargement, along with the relief of subvalvular muscular
obstruction.
Patients and methods
The Konno-type aorto-ventriculoplasty is preferred in the present case series in order
to achieve a radical aortic annulus enlargement in difficult reoperation settings
and to address the accompanying subvalvular obstruction due to muscular hypertrophy
simultaneously as well, with the septal patch included in the technique.
Results
This approach provides satisfactory relief of the obstruction at both valvular and
subvalvular level and the benefits are immediately evident, as symptoms abruptly end
in all cases.
Conclusion
Long-term outcome is also excellent in both clinical and haemodynamic terms, as reflected
by the significant left ventricle mass regression, absence of symptoms and improved
quality of life.
Keywords
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References
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Article info
Publication history
Published online: December 06, 2013
Accepted:
October 31,
2013
Received in revised form:
October 25,
2013
Received:
September 23,
2013
Identification
Copyright
© 2013 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
