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Biomedical subjects

J Koncz

Publications and source records attributed to J Koncz.

At least 37 records · Page 2Linked to original sources

Aortoventriculoplasty: a new technique for the treatment of left ventricular outflow tract obstruction.

Aortoventriculoplasty is a new method of treatment for left ventricular outflow tract obstructions. The concept is based on creating a surgical defect which is patched in such a way as to provide the largest possible outflow to the left ventricle. The incision of the aorta continues down as far as necessary, with the right ventricular wall, the aortic ring, and the septum being cut. Reconstruction with an inner Dacron patch on the septum is completed by replacing the aortic valve with an adequate prosthesis, covering the aortic incision with the same patch, and patching the right venticular opening with an outer patch. This method was used in 4 children with tunnel-like subaortic stenosis, 3 of whom had had unsuccessful previous surgical attempts. Other associated lesions including parachute mitral valve were also corrected during aortoventriculoplasty. Hemodynamic results were excellent following this operation. Two patients died postoperatively, one from advanced myocardial damage and progressive failure and the other from cerebral ischemia caused by insufficient retrograde perfusion through an aortic coarctation that was not repaired earlier. No arrhythmias were observed following the procedure. The other 2 patients are well 7 and 5 months postoperatively with excellent hemodynamic function.

Angiocardiography↗

[Plastic enlargement of the left ventricular outflow tract. A new operative method (author's transl)].

A new operative technic for widening the stenotic left ventricular outflow ("left ventricular tunnel") is described and a clinical case is reported. A vertical incision along the anterior aspect of the aorta descends with a slight angle across the outflow tract of the right ventricle. After aortic valvectomy the ventricular septum is cut between the left and right coronary commissure through its full thickness and the incision extended inferiorly across the stenotic area. A dacron patch is sewn into the gap of the septum and aortotomy in order to widen the area of previous stenosis and prosthetic replacement of the aortic valve is performed. Finally another dacron patch is used to close the defect in the right ventricular outflow tract.

Aorta↗

[Ventricular septal defect associated with fibrous subvalvular aortic stenosis: problems in the diagnosis and in the surgical management (author's transl)].

Only 9 of more than 900 operated patients with ventricular septal defects suffered from this rare combination. The problems of the diagnosis are discussed. Only in one case this diagnosis was made praeoperatively, in 6 cases intraoperatively and in two cases only postoperatively. In the last two cases a reoperation was necessary. The surgical methods are described and the results of surgery are communicated.

Adolescent↗

[Pre- and postoperative examinations in congential aortic stenoses].

70 patients with congenital aortic stenosis had been operated upon between the age of 7 months and 23 years (average 8 years). For evaluation of the surgical result recatheterization and angiocardiography had been carried out on all patients between 1 and 12 years after operation (mean 7 years). The pre- and postoperative catheter findings, angiocardiograms, ECG, heart-size and clinical findings were analysed and compared with each other. In 2/3 of the cases the operative results could be defined as good or satisfactory. In the last third the operative results had been poor and a reoperation unavoidable. In half of the cases the poor results had been due to a significant residual aortic stenosis and in the other half it was due to massive aortic regurgitation. The prognosis and the indication to operation had been discussed.

Adolescent↗