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Doi T, Nagao K, Obi H, Higashida A, Aoki M, Yokoyama S, Nagura S, Yamashita S, Yamashita A, Fukahara K, Yoshimura N. Application of the Konno procedure for infective endocarditis in native bicuspid aortic valve with annular abscess extending into the interventricular septum. J Surg Case Rep 2021; 2021:rjab428. [PMID: 34584668 PMCID: PMC8462466 DOI: 10.1093/jscr/rjab428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 09/04/2021] [Indexed: 11/14/2022] Open
Abstract
Annular abscess is a serious complication of infective endocarditis, which often requires complex surgery and has a very high post-operative mortality rate. The Konno procedure involves valve annuloplasty for a narrow aortic annulus or left ventricular outflow tract stenosis in children; it is also performed for various cardiac conditions in adults. Here, we report a case of the Konno procedure performed in a patient with aortic valve infective endocarditis, with an annular abscess extending into the interventricular septum (IVS). A 58-year-old man who presented to our hospital with fever was diagnosed with aortic valve infective endocarditis caused by Streptococcus saccharolyticus. On echocardiography, an annular abscess in the direction of the IVS was detected, and surgery was planned. The Konno procedure was performed to secure an adequate surgical field and to debride and reconstruct the cavity created by the interventricular septal abscess. The patient was discharged uneventfully 29 days after surgery.
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Affiliation(s)
- Toshio Doi
- First Department of Surgery, University of Toyama, Toyama, Japan
| | - Kanetsugu Nagao
- First Department of Surgery, University of Toyama, Toyama, Japan
| | - Hayato Obi
- Department of Cardiovascular Surgery, JA Nagano Koseiren Shinonoi General Hospital, Nagano, Japan
| | | | - Masaya Aoki
- First Department of Surgery, University of Toyama, Toyama, Japan
| | - Shigeki Yokoyama
- First Department of Surgery, University of Toyama, Toyama, Japan
| | - Saori Nagura
- Department of Cardiovascular Surgery, JA Nagano Koseiren Shinonoi General Hospital, Nagano, Japan
| | | | - Akio Yamashita
- First Department of Surgery, University of Toyama, Toyama, Japan
| | - Kazuaki Fukahara
- First Department of Surgery, University of Toyama, Toyama, Japan
| | - Naoki Yoshimura
- First Department of Surgery, University of Toyama, Toyama, Japan
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Oh HK, Kim NY, Kang MW, Kang SK, Yu JH, Lim SP, Choi JS, Na MH. Aortic periannular abscess invading into the central fibrous body, mitral valve, and tricuspid valve. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2014; 47:283-6. [PMID: 25207228 PMCID: PMC4157481 DOI: 10.5090/kjtcs.2014.47.3.283] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Revised: 10/30/2013] [Accepted: 11/05/2013] [Indexed: 11/23/2022]
Abstract
A 61-year-old man was diagnosed with aortic stenoinsufficiency with periannular abscess, which involved the aortic root of noncoronary sinus (NCS) that invaded down to the central fibrous body, whole membranous septum, mitral valve (MV), and tricuspid valve (TV). The open complete debridement was executed from the aortic annulus at NCS down to the central fibrous body and annulus of the MV and the TV, followed by the left ventricular outflow tract reconstruction with implantation of a mechanical aortic valve by using a leaflet of the half-folded elliptical bovine pericardial patch. Another leaflet of this patch was used for the repair of the right atrial wall with a defect and the TV.
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Affiliation(s)
- Hyun Kong Oh
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea
| | - Nan Yeol Kim
- Department of Thoracic and Cardiovascular Surgery, Chonnam National University Medical School, Korea
| | - Min-Woong Kang
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea
| | - Shin Kwang Kang
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea
| | - Jae Hyeon Yu
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea
| | - Seung Pyung Lim
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea
| | - Jae Sung Choi
- Department of Thoracic and Cardiovascular Surgery, SMG-SNU Boramae Medical Center, Korea
| | - Myung Hoon Na
- Department of Thoracic and Cardiovascular Surgery, Chungnam National University School of Medicine, Korea
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Konno procedure for prosthetic aortic valve endocarditis: 34-year follow-up. Ann Thorac Surg 2011; 93:302-4. [PMID: 22186453 DOI: 10.1016/j.athoracsur.2011.06.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 06/07/2011] [Accepted: 06/22/2011] [Indexed: 11/20/2022]
Abstract
A 34-year follow-up is described after a Konno aortoventriculoplasty to correct a restricted aortic annulus and a recurrent aortic prosthetic valve endocarditis with subannular and interventricular abscesses.
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Goh K, Yamamoto H, Tsuda N, Sasajima T. Konno procedure for infective endocarditis involving aortic valve in a small child. Ann Thorac Surg 2000; 69:1264-6. [PMID: 10800838 DOI: 10.1016/s0003-4975(99)01453-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
The Konno procedure was performed to replace the aortic valve and the sinus of Valsalva in a 1-year-old child with pneumococcal infective endocarditis. A Dacron (C.R. Bard, Haverhill, PA) graft and a 16 AP ATS Medical valve (ATS Medical Inc, Minneapolis, MN) were used. Adequate debridement could be easily performed. Postoperative recovery was uneventful. The procedure, originally developed for a narrow aortic annulus, could be a good option for the treatment of a small child with aortic valve endocarditis.
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Affiliation(s)
- K Goh
- First Department of Surgery, Asahikawa Medical College, Japan.
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Rajasekhar D, Manoj P, Dilip D. Aorto-Left Atrial Fistula Complicating Native Aortic Valve Endocarditis. Asian Cardiovasc Thorac Ann 1999. [DOI: 10.1177/021849239900700319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 21-year-old male with native aortic valve Streptococcus viridans endocarditis was found to have an aorto-left atrial fistula by transthoracic echocardiography. He underwent successful fistula plication and aortic valve replacement.
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Affiliation(s)
| | - Padmanabhan Manoj
- Department of Cardiothoracic Surgery Sri Venkateswara Institute of Medical Sciences Tirupati, Andhra Pradesh, India
| | - Dronamraju Dilip
- Department of Cardiothoracic Surgery Sri Venkateswara Institute of Medical Sciences Tirupati, Andhra Pradesh, India
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Kameyama T, Ando F, Okamoto F, Hanada M, Sasahashi N. A brimmed valved conduit in repair of fibrous skeleton abscess. Ann Thorac Surg 1998; 66:2108-10. [PMID: 9930509 DOI: 10.1016/s0003-4975(98)00765-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Aortomitral common annular involvement, which is not uncommon in infective endocarditis, necessitates deliberate surgical procedures. To repair fibrous skeleton abscess accompanied with annuloaortic ectasia, we used a brimmed valved conduit. Tension-free reconstruction of the aortic root and aortomitral common annulus was easily performed with this method.
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Affiliation(s)
- T Kameyama
- Department of Cardiovascular Surgery, Hyogo Kenritsu Amagasaki Hospital, Japan
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