The Konno-Rastan Procedure for Anterior Aortic Annular Enlargement

An anterior aortoventriculoplasty, known as the Konno-Rastan procedure, is a useful tool for the cardiac surgeon. Originally, described for congenital aortic stenosis secondary to small annular size, it relieves subvalvar, valvar, and supravalvar stenosis. We show a step by step, illustrated, and safe approach to perform this operation. Although this is unusual anatomy outside the congenital arena, it is a relatively safe and straight-forward procedure. When compared with a homograft or xenograft root replacement, the Konno-Rastan has the benefit of not having to mobilize the coronaries as well as ease of valve replacement.