The fate of the neoaortic valve and root following the modified Ross-Konno

• Published in: Journal Of The Saudi Heart Association 2013-04, Vol.25 (2), p.136-137
• Main Authors: Al Abri, I., Al-Halees, Z., Al-Fayyadh, M., Al-Bulbul, Z., Al-Ahmadi, M., Alsoufi, B.
• Format: Article
• Language: English
• ISSN: 1016-7315; 2212-5043
• DOI: 10.1016/j.jsha.2013.03.088

In children with aortic valve disease associated with annular hypoplasia or complex multi-level left ventricular outflow tract obstruction (LVOTO), the Ross procedure, combined with a modified Konno-type aortoventriculoplasty is advocated. We aim to examine the fate of the neoaortic apparatus and assess neoaortic valve function following the modified Ross-Konno procedure. Forty-three patients, median age 6 years, underwent modified Ross- Konno with myectomy but without ventricular septal patch utilization. Serial postoperative echocardiograms (n=187) were analyzed and regression models adjusted for repeated measures were used to model longitudinal growth of neoaortic annulus and root. There were 2 operative deaths (5%) and 1 late mortality. At 8 years, survival was 93% and freedom from autograft, homograft and all-cause reoperation was 100%, 81%, and 72%, respectively. Median post-procedure diameter and Z-score were 14mm (7–21mm), and 1.25 (−3 to +6.1) for neoaortic annulus and 21mm (9–30mm) and 1.55 (−1.3 to +4.1) for neoaortic root. Serial echocardiograms showed progressive increase in annular (+0.56mm/year, p