Impact of Konno Procedure on Right Heart Function

Background: The Konno procedure, a left-sided surgical intervention, can lead to right-sided heart failure postoperatively due to pulmonary or tricuspid valve dysfunction. Case Summary: A 62-year-old woman with prior mechanical aortic and mitral valve replacements underwent a Konno procedure. She later presented with severe right heart failure and was found to have right ventricular enlargement, mitral patient-prosthesis mismatch, an iatrogenic ventricular septal defect, and severe pulmonic and tricuspid regurgitation. Discussion: At even the most experienced centers, Konno is associated with up to 16% significant pulmonary valve disruption. Timely recognition and management of complications of procedures like the Konno will become more important with the increasing complexity of patients undergoing invasive management. Take-Home Messages: Identification and successful management of complications after complex surgical procedures require careful evaluation, and a high index of suspicion tailored to the surgical approach. Furthermore, these complex patients may benefit from contemporary advances in transcatheter valve technology.