Ross手术治疗主动脉瓣病变

Treating aortic valve disease with the Ross procedure

目的 探讨Ross手术主动脉根部置换技术 ,总结临床经验。方法 1994年 10月至 2 0 0 2年5月为 7例主动脉瓣病变者行Ross手术。右室流出道重建均采用同种异体肺动脉。其中男 4例 ,女 3例 ;年龄 11～ 44岁 ,平均 ( 2 8± 10 )岁。 7例均有重度主动脉瓣关闭不全 ,伴有中度狭窄 2例 ,二瓣畸形和房、室间隔缺损各 1例 ;7例肺动脉瓣均正常。结果 全组无手术死亡。术后随访 3～ 78个月 ,1例 3年后因感染性心内膜炎二次手术死亡 ;其余 6例超声心动图显示主动脉瓣无反流 ,肺动脉瓣功能正常 ,左心室舒张末径明显缩小 ,心功能正常。结论 尽管Ross手术技术有一定的难度 ,但其恢复瓣膜性能和远期疗效良好。

Objective: To study the Ross procedure in surgery for aortic valve disease. Methods: From October, 1994 to May, 2002, 7 patients underwent Ross operation for aortic valve diseases. Pulmonary homografts were used for reconstruction of right ventricular outflow tract (RVOT). Among them, male 4, female 3, age from 11 to 44 years old [average (28±10) years]. All had severe aortic valve regurgitation, 2 associated with moderate aortic valve stenosis, 1 with bicuspid aortic valve, 1 with atrium septal defect, and 1 with ventricular septal defect. Pulmonary valve function was normal in all patients. Results: There was no operative death. One patient died 3 years later of SBE. Echocardiography indicated the normal function of aortic and pulmonary valve and excellent heart function. Conclusion: Ross operation provides is difficult but yields excellent clinical results.