| Valve and Conduit Replacements |
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Aortic Stenosis - Konno Procedure
This procedure is performed in cases of Aortic Stenosis when the left ventricular outflow tract is stenotic in addition to the aortic valve itself. It involves the replacement of the aortic valve and the widening of the ventricular septum in the region of the valve with a patch (see illustration).
The aortic valve is replaced with either a mechanical valve (Konno-Rastan Procedure), an aortic homograft (human aortic valve), or with the patient's own pulmonary valve. In the last case, the valve may grow and renew itself over time. However, the first two types of replacement valve will eventually need to be replaced as the function over time decreases.
After the Konno Procedure, the possibility of renewed narrowing of the left ventricular outflow tract (LVOT) exists and the patient will need regular monitoring. The development of a new systolic murmur or the intensification of a soft murmur is an indication that the LVOT should be investigated through echocardiography.
The aortic valve itself also needs to be monitored to guard against progressive aortic insufficiency. If this becomes significant, reoperation will be necessary. However, significant aortic insufficiency is uncommon in the adult patient and mild insufficiency is well-tolerated and generally remains stable for long periods.
Most surgically implanted mechanical valves will last 10-20 years before they wear out, become obstructed, or lose efficiency. When their function becomes impaired for any of these reasons, replacement becomes necessary. |
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