Reoperation for prosthetic valve degeneration after Konno aortoventriculoplasty

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Since the introduction of the aortoventriculoplasty procedure by Konno in 1975, 16 patients have undergone aortic root augmentation by this method at the Woodruff Medical Center of Emory University. In four patients bioprosthetic valve degeneration 2 to 5 years after the Konno procedure has necessitated repeat operation and replacement of the prosthetic aortic valve. Modification of the septal patch or repeat right ventriculotomy has not been required. One patient required an additional lateral anulus-enlargement procedure (Manouguian) whereas the other three have demonstrated stability or growth of the aortic anulus. We have not observed recurrent subvalvular stenosis or problems with the right ventricular outflow tract. Repeat operation after aortoventriculoplasty has been relatively simple and has usually involved only the supra-annular aorta.