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Twenty-year experience with the Konno operation: Konno incision does not impair LV function

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Abstract

Background

There has been no report observing the LV function of Konno incision. We examined the outcomes of the Konno operations over 20 years.

Methods

We investigated 63 Konno operations with mechanical valves performed from 1984. This study aimed to evaluate the effects of Konno incision including LV function changes and the long-term outcomes of patient survival and reoperation rate (RVOT and LVOT complications).

Results

The postoperative follow-up period was 20.6 ± 6.2 years. Early death occurred in 1 case and late death occurred in 9 cases. The cumulative survival rate was 89.6, 87.5, and 84.5% in the 5th, 10th, and 20th follow-up years. Five patients required reoperation for the aortic valve. The recurrence avoidance rate for LVOT reoperation was 96.6, 94.7, and 92% in the 5th, 10th, and 20th follow-up years of the Konno operation. Konno incision did not show significant decline in postoperative LV ejection fraction. (Pre, 62% vs 20 years later, 58%; P = 0.052.) There were no cases requiring intervention at the event of ventricular arrhythmia, but 13 cases were Complete Right bundle branch block, and 11 cases were Left bundle branch block.

Conclusions

The survival rate associated with Konno operation throughout 20 years was excellent. Konno incision can secure sufficient LV outflow tract and is a safe treatment for complex LVOTO without deteriorating LV ejection fraction.

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Abbreviations

LVOT PG:

Light ventricular outflow tract pressure gradient

RVOT PG:

Right ventricular outflow tract pressure gradient

AR:

Aortic valve regurgitation

AS:

Aortic valve stenosis

ASR:

Aortic valve stenosis and regurgitation

CPB:

Cardiopulmonary bypass

IE:

Infective endocarditis

LV:

Left ventricular

LVOT:

Left ventricular outflow tract

LVOTO:

Left ventricular outflow tract obstruction

MVR:

Mitral valve replacement

RV:

Right ventricular

RVOT:

Right ventricular outflow tract

SJM:

St. Jude medical prosthesis

PS:

Pulmonary valve stenosis

PTA:

Percutaneous transluminal angiography

e-PTFE:

Expanded-polytetrafluoroethylene

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Authors and Affiliations

  1. Department of Cardiovascular Surgery, The Heart Institute of Japan, Tokyo Women’s Medical University, 8-1 Kawada-cho, Shinjyuku-ku, Tokyo, 162-8666, Japan

    Yuichi Matsuzaki, Takeshi Hiramatsu, Takahiko Sakamoto, Mitsugi Nagashima, Hiroshi Niinami & Kenji Yamazaki

Authors
  1. Yuichi Matsuzaki
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  2. Takeshi Hiramatsu
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  3. Takahiko Sakamoto
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  4. Mitsugi Nagashima
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  5. Hiroshi Niinami
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  6. Kenji Yamazaki
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Correspondence to Yuichi Matsuzaki.

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Matsuzaki, Y., Hiramatsu, T., Sakamoto, T. et al. Twenty-year experience with the Konno operation: Konno incision does not impair LV function. Gen Thorac Cardiovasc Surg 66, 270–275 (2018). https://doi.org/10.1007/s11748-018-0896-z

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  • DOI: https://doi.org/10.1007/s11748-018-0896-z

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