Aortoventriculoplasty ad modum Konno. Experience with five cases.

We have performed Konno's aortoventriculoplasty in 5 children with congenital valvular aortic stenosis and extreme annular narrowing. There was one hospital death, unrelated to the surgical procedure per se. Bleeding from the stitch holes along the patches immediately after bypass was the sole problem associated with the Konno operation in our 4 surviving patients. Preclotting of the dacron patch or use of calf pericardium did not significantly influence this type of bleeding complication. Konno's aortoventriculoplasty permitted considerable enlargement of the original annular circumference and insertion of a size of prosthesis appropriate for adult life (at least 21 mm tissue diameter) in the 4 survivors. The results were still good 1 to 5 (mean 3) years after surgery. The Konno operation is a safe procedure, which widens the hypoplastic aortic annulus to a possible maximum, relieves most forms of ventricular outflow tract obstruction and maintains the prosthetic valve in anatomic sub-coronary position, so that a left ventricular apical-aortic conduit is not required.