Late left ventricular function after successful Ross-Konno operation

Background: The changes of left ventricular function after undergoing a Ross-Konno operation for pediatric patients with multiple-level left ventricular outflow tract obstruction are still unclear.

Methods: From 1996 to 2006, 14 patients younger than 20 years underwent a Ross-Konno operation. The mean age at the time of the operation was 6.6 ± 5.7 years. A postoperative catheter examination was performed at early (1.0 ± 0.4 years after the operation, n = 13), mid (3.3 ± 1.6 years, n = 9), and late (8.5 ± 2.5 years, n = 6) periods. The mean follow-up period was 10.1 ± 6.0 years (range, 0.1 to 17.2 years).

Results: There was 1 early death and no late deaths. The pressure gradient across the left ventricular outflow tract was well relieved from 62.4 ± 22.9 mm Hg at the preoperative period to 4.5 ± 7.2 mm Hg at the early postoperative period, 4.1 ± 3.5 mm Hg at the mid postoperative period, and 3.8 ± 3.7 mm Hg at the late postoperative period. The left ventricular ejection fraction significantly decreased from 0.73 ± 0.12 at the preoperative period to 0.60 ± 0.10 at the early postoperative period (p = 0.00035), then improved to 0.64 ± 0.14 at the late postoperative period. The left ventricular end-diastolic volume normalized to 103 ± 37% of the normal volume at the late postoperative period. However, the left ventricular end-diastolic pressure did not decrease from 15.2 ± 6.1 mm Hg at the preoperative period, 12.5 ± 3.3 mm Hg at the early postoperative period, 13.1 ± 5.1 mm Hg at the mid postoperative period, or 12.7 ± 5.6 mm Hg at the late postoperative period.

Conclusions: The left ventricular contraction and volume normalized long after the Ross-Konno operation. However, the reduced ventricular compliance did not recover, although left ventricular outflow tract obstruction was well relieved.