Key result
The classic Konno-Rastan procedure for diffuse subaortic stenosis resulted in an 11.5% 30-day mortality and significantly decreased the mean peak systolic gradient from 91.3 to 28.1 mm Hg.
Why the study?
Does the classic Konno-Rastan procedure using a mechanical valve effectively relieve obstruction in patients with diffuse subaortic stenosis?
Cohort (n=26)
No
Does the classic Konno-Rastan procedure using a mechanical valve effectively relieve obstruction in patients with diffuse subaortic stenosis?
The classic Konno-Rastan procedure using a mechanical valve effectively reduces peak systolic gradient in diffuse subaortic stenosis with acceptable morbidity and mortality.
Supports gradient relief with classic Konno-Rastan in diffuse subaortic stenosis; leaves open need for comparative trials on durability and alternatives.
Diffuse or unresectable subaortic stenosis is difficult to treat and needs aggressive resection to effectively relieve the obstruction. Anterior aortoventriculoplasty, known as the Konno-Rastan procedure, has been shown to effectively tackle the problems encountered in diffuse subaortic stenosis. A retrospective study was carried out on patients who had undergone a Konno-Rastan procedure at our institution from March 1997 to November 2003. There were 26 patients (16 males and 10 females). The mean age at operation was 12.8 +/- 7 years. The mean follow-up period was 30.4 +/- 14.5 months. Only mechanical valves were used in this group of patients. The overall 30-day mortality was 11.5% (3 patients). The mean preoperative peak systolic gradient decreased significantly from 91.3 +/- 39.3 to 28.1 +/- 17.7 mm Hg. Four patients developed permanent complete heart block and 2 had a residual ventricular septal defect in late follow-up. The classic Konno-Rastan procedure using a mechanical valve can be performed with acceptable morbidity and mortality in this difficult group of patients.
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Tabatabaie et al. (2006) conducted a cohort in Diffuse or unresectable subaortic stenosis (n=26). Classic Konno-Rastan procedure was evaluated on 30-day mortality. The classic Konno-Rastan procedure for diffuse subaortic stenosis resulted in an 11.5% 30-day mortality and significantly decreased the mean peak systolic gradient from 91.3 to 28.1 mm Hg.
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