摘要
目的分析影响Ross手术后中、远期主动脉瓣反流的危险因素。方法自1998年3月至2007年7月，47例主动脉瓣瓣膜疾病病人接受Ross手术，其中男25例，女22例；平均年龄（13．31±5．79）岁。术前诊断风湿性心脏病6例，先天性心脏病41例。病人均采用经胸超声评价主动脉瓣反流情况。采用Logistic回归分析主动脉瓣反流危险因素。结果全部病例随访（36．15±22．1）个月，均生存。主动脉窦径及主动脉瓣环直径均较术前明显增加，新主动脉瓣免于轻度以上反流率为82．9％。Logistic回归分析发现，术前主动脉瓣二瓣化畸形、术前主动脉瓣环扩大及病人年龄大于14岁为术后主动脉瓣反流的危险因素。结论Ross手术治疗主动脉瓣膜疾病安全、有效，主动脉瓣可随机体发育而生长，其中、远期效果满意。年龄大于14岁、术前主动脉瓣环扩大及术前主动脉瓣二瓣化畸形是增加Ross手术后主动脉瓣反流的危险因素。
Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure（pulmonary valve homograft transplantation）. Methods Between March 1998 and July 2007, 47 patients [ 25 male, 22 female, mean age （13.31 ± 5.79） years, range 1-34 years] with aortic valvular disease underwent the Ross procedure at our institution. There were 6 patients suffering from rheamafic heart disease and 41 patients suffering from congenital heart disease. The average aortic blood flow velocity was （4.67 ± 3.47） m/s, the average pressure gradient across aortic valve （88.26 ±58.06） mm Hg, LVEDD （45.53 ± 10.78） mm EF 0.69 ± 0.08. All the patients were followed up in out-patient department by ultrasenie cardiogram. Multiple logistic regression analysis was performed to find out the risk factors of the postoperative aortic valvular regurgitation. Results There was no postoperative death in hospital, The mean follow-up periods was （36.15± 22.1 ） months, range from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diameters of the aortic sinus and aortic annulus enlarged significantly, respectively from （26.16 ± 5.10） mm to （32.37 ± 6.84 ） mm and from （19.41± 3.98） mm to （23.45± 5.86） mm. The average flow velocity of the homograft （ new aortic valve） was（ 1.39±0.48） m/s, gradient pressure （8.17 ±6.16） mm Hg. Mild aortic regurgitation was present in 5 patients （ 10.6% ）, moderate aortic regurgitation in 2 patients （4.3%） and severe aortic regurgitation in 1 patient （2.1% ）. The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the presence of bieuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for postoperative aortic regurgitafien. The Ross procedure is a safe and effective procedure with good clinical results in mid- and long-term follow-up. However, the preface of bicuspid aortic valve, enlarg
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2009年第3期156-158,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
关键词
主动脉瓣
心脏外科手术
主动脉瓣反流
Aortic valve Cardiac surgical procedures Aortic valve insufficiency
