Aortic stenosis and aortic insufficiency in children: impact of valvuloplasty and modified Ross-Konno procedure.
Aortic stenosis and aortic insufficiency in young children present multiple challenges to the patient, family, and surgeon. Mechanical valves require anticoagulation therapy, which is a poor option in active youngsters and noncompliant adolescents. Aortic valvuloplasty and the various forms of the Ross/Ross-Konno operations appear to be good solutions in this patient population due to valve preservation for the former and autograft growth for the latter. However, valvuloplasty failure and autograft dilatation have developed in some patients. In addition, heart block remains a problem in those patients who require an annular enlarging operation. We review our experience with the various forms of valvuloplasty, Ross operation, Konno operation, Ross-Konno operation, and the modified Ross-Konno operation, which we have used to eliminate heart block in patients who require an annular enlarging operation.
Center for Pediatric and Congenital Heart Diseases, Cleveland Clinic Children's Hospital, Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, OH, USA. mavrouc@ccf.org
Constantine
C
Mavroudis
Carl L
CL
Backer
Sunjay
S
Kaushal
D000293:Adolescent; D001022:Aortic Valve Insufficiency / Q000151:congenital / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012086:Reoperation; D014182:Transplantation, Autologous