ニイナミ　ヒロシ   Niinami Hiroshi   新浪　博    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Twenty-year experience with the Konno operation: Konno incision does not impair LV function.
掲載誌名	正式名：General thoracic and cardiovascular surgery 略　 称：Gen Thorac Cardiovasc Surg ISSNコード：18636705/18636713
掲載区分	国内
出版社	Springer Nature
巻・号・頁	66(5),pp.270-275
著者・共著者	MATSUZAKI Yuichi†*, HIRAMATSU Takeshi, SAKAMOTO Takahiko, NAGASHIMA Mitsugi, NIINAMI Hiroshi, YAMAZAKI Kenji
発行年月	2018/05
概要	BACKGROUND:There has been no report observing the LV function of Konno incision. We examined the outcomes of the Konno operations over 20 years. METHODS:We investigated 63 Konno operations with mechanical valves performed from 1984. This study aimed to evaluate the effects of Konno incision including LV function changes and the long-term outcomes of patient survival and reoperation rate (RVOT and LVOT complications). RESULTS:The postoperative follow-up period was 20.6 ± 6.2 years. Early death occurred in 1 case and late death occurred in 9 cases. The cumulative survival rate was 89.6, 87.5, and 84.5% in the 5th, 10th, and 20th follow-up years. Five patients required reoperation for the aortic valve. The recurrence avoidance rate for LVOT reoperation was 96.6, 94.7, and 92% in the 5th, 10th, and 20th follow-up years of the Konno operation. Konno incision did not show significant decline in postoperative LV ejection fraction. (Pre, 62% vs 20 years later, 58%; P = 0.052.) There were no cases requiring intervention at the event of ventricular arrhythmia, but 13 cases were Complete Right bundle branch block, and 11 cases were Left bundle branch block. CONCLUSIONS:The survival rate associated with Konno operation throughout 20 years was excellent. Konno incision can secure sufficient LV outflow tract and is a safe treatment for complex LVOTO without deteriorating LV ejection fraction.
DOI	10.1007/s11748-018-0896-z
PMID	29396657