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KMID : 0364019900230010192
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Korean Journal of Thoracic and Cardiovascular Surgery
1990 Volume.23 No. 1 p.192 ~ p.200
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Experience of Modified Konno Operation in Patients with LVOTO
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Abstract
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The results of conventional operative resection of diffuse subaortic stenosis(tunnel subaortic stenosis) have been less than satisfactory.
We have performed modified Konno operation to enlarge the outflow tract of both ventricle with a patch in three patients with diffuse tunnel subaortic stenosis in the department of Thoracic and Cardiovascular Surgery, Seoul National University Children´s Hospital. Preaperative left ventricular aortic pressure gradients were 135 mmHg, 50 mmHg, 80 mmHg respectively in these patients.
After right ventriculotomy, the septotomy was done and extended beyond the limit of the stenosis and fibrous and/or muscular tissue was removed from each edge of septal incision. After adequate widening of the tunnel subaortic stenosis with various patches, right ventricle was closed primarily or with prosthetic patches sucessfully.
One patient who was diagnosed as complete atrioventricular septal defect had complete AV block preoperatively and was implanted permanent pacemaker, and others who were sinus rhythm preoperatively have no serious postoperative rhythm disturbance.
One patient developed mild postoperative aortic insufficiency and one who had preoperative aortic insufficiency has still same grade of aortic insufficiency after operation.
All had good postoperative hemodynamics without any postoperative residual pressure gradient.
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KEYWORD
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