(Figure from Kirklin/Barrat-Boyes Cardiac Surgery 3rd Ed. p1292)Ross-Konno Procedure:
Methods to enlarge aortic annulus: (Antionio F. Corno "Congenital Heart Defects - Decision making for surgery" Vol.1)
1) Posterior annular enlargement:
Nicks - aortotomy extended through non-coronary sinus and anterior mitral leaflet (prosthetic patch).
2) Managouian - aortotomy extended through left and non-coronary sinuses and anterior mitral leaflet (prosthetic patch).
Aortic Valve sparing:
Jonas modification to preserve aortic valve annulus - for tunnel-type SubAS and mitral stenosis (needing enlargement of mitral annulus), but aortic valve annulus is adequate - aortotomy extended via commissure between NCC & LCC and extend the incision across mitral annulus to roof of LA. Replace mitral valve with prosthesis and a triangular patch to enlarge mitral annulus and close LA incision. Aorta is closed preserving aortic valve annulus. (Jonas RA et al. JTCVS 1998;115:1219)