title: The Ross, Konno, and Ross-Konno operations for congenital left ventricular outflow tract abnormalities.
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.
authors: 1Johns Hopkins Children's Heart Surgery,Florida Hospital for Children,Orlando,Florida,United States of America.
authors: Constantine
authors: C
authors: Mavroudis
authors: 2Division of Cardiovascular Surgery,University of PennsylvaniaDepartment of Surgery,Philadelphia,Pennsylvania,United States of America.
authors: Constantine D
authors: CD
authors: Mavroudis
authors: 3Johns Hopkins Children's Heart Surgery,All Children's Hospital,St Petersburg,Florida,United States of America.
authors: Jeffrey P
authors: JP
authors: Jacobs
mesh_terms: D001021:Aortic Valve / Q000601:surgery; D001022:Aortic Valve Insufficiency / Q000151:congenital / Q000601:surgery*; D001024:Aortic Valve Stenosis / Q000151:congenital / Q000601:surgery*; D000082882:Bicuspid Aortic Valve Disease; D006348:Cardiac Surgical Procedures / Q000379:methods*; D006330:Heart Defects, Congenital / Q000601:surgery; D006349:Heart Valve Diseases / Q000151:congenital / Q000601:surgery; D006801:Humans; D011664:Pulmonary Valve / Q000637:transplantation*; D014694:Ventricular Outflow Obstruction / Q000151:congenital / Q000601:surgery*
keywords: supravalvar aortic stenosis