title: Late left ventricular function after successful Ross-Konno operation.
abstract: BACKGROUND
  The changes of left ventricular function after undergoing a Ross-Konno operation for pediatric patients with multiple-level left ventricular outflow tract obstruction are still unclear.
  
  
  METHODS
  From 1996 to 2006, 14 patients younger than 20 years underwent a Ross-Konno operation. The mean age at the time of the operation was 6.6 ± 5.7 years. A postoperative catheter examination was performed at early (1.0 ± 0.4 years after the operation, n = 13), mid (3.3 ± 1.6 years, n = 9), and late (8.5 ± 2.5 years, n = 6) periods. The mean follow-up period was 10.1 ± 6.0 years (range, 0.1 to 17.2 years).
  
  
  RESULTS
  There was 1 early death and no late deaths. The pressure gradient across the left ventricular outflow tract was well relieved from 62.4 ± 22.9 mm Hg at the preoperative period to 4.5 ± 7.2 mm Hg at the early postoperative period, 4.1 ± 3.5 mm Hg at the mid postoperative period, and 3.8 ± 3.7 mm Hg at the late postoperative period. The left ventricular ejection fraction significantly decreased from 0.73 ± 0.12 at the preoperative period to 0.60 ± 0.10 at the early postoperative period (p = 0.00035), then improved to 0.64 ± 0.14 at the late postoperative period. The left ventricular end-diastolic volume normalized to 103 ± 37% of the normal volume at the late postoperative period. However, the left ventricular end-diastolic pressure did not decrease from 15.2 ± 6.1 mm Hg at the preoperative period, 12.5 ± 3.3 mm Hg at the early postoperative period, 13.1 ± 5.1 mm Hg at the mid postoperative period, or 12.7 ± 5.6 mm Hg at the late postoperative period.
  
  
  CONCLUSIONS
  The left ventricular contraction and volume normalized long after the Ross-Konno operation. However, the reduced ventricular compliance did not recover, although left ventricular outflow tract obstruction was well relieved.
authors.affiliation: Department of Pediatric Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan. thoashi@surg1.med.osaka-u.ac.jp
authors.forename: Takaya
authors.initials: T
authors.lastname: Hoashi
authors.forename: Koji
authors.initials: K
authors.lastname: Kagisaki
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kurosaki
authors.forename: Isao
authors.initials: I
authors.lastname: Shiraishi
authors.forename: Toshikatsu
authors.initials: T
authors.lastname: Yagihara
authors.forename: Hajime
authors.initials: H
authors.lastname: Ichikawa
mesh_terms: D000293:Adolescent; D001021:Aortic Valve / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans; D007223:Infant; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D016277:Ventricular Function, Left; D014694:Ventricular Outflow Obstruction / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult