Rózański Jacek, Kusmierczyk Mariusz, Siudalska Hanna, Matlak Krzysztof, Sitko Tadeusz, Juraszyński Zbigniew, Hoffmań Piotr
I Klinika Kardiochirurgii Instytutu Kardiologii w Warszawie.
Pol Merkur Lekarski. 2003 Nov;15(89):402-5.
The aim of this study was to establish the indications to use of pulmonary autograft in the treatment of aortic valve disease in the adolescents and adults; early and mid-term an evaluation of autograft's function and function of left ventricle after Ross operation. In this procedure the patient's own pulmonary valve is removed together with the main trunk of the pulmonary artery and used to replace the aortic valve. Pulmonary homograft is used to reconstruction of right ventricular outflow tract. Between February 1994 and march 2001 in 1st Cardiac Surgery Department in 43 patients over 14 years of age Ross operation have performed. Mean age was 24.9 years. Indications for operation were predominant aortic stenosis in 29 patients, aortic incompetence in 7 patients, and complex aortic valve disease in 7 patients. Hospital mortality was 4.6%. In mid-term observation 41 patients left. All survivors remained in New York Heart Association functional class I and were free of complications and medications. In the all patients autograft's valve have functioned excellent (without or small regurgitation). Echocardiographic parameters of left ventricular function improved in the all patients. The indications to pulmonary autograft insertion in the adolescents and adults are small aortic ring, infective endocarditis and contraindications to anticoagulants using. The early and mid-term results confirm a high efficacy Ross operation in this age's group with low mortality. It completely relieves the abnormal loading conditions of the left ventricle, resulting in a complete recovery of left ventricular function.
本研究的目的是确定在青少年和成人主动脉瓣疾病治疗中使用肺动脉自体移植的指征；对Ross手术后自体移植瓣膜功能及左心室功能进行早期和中期评估。在此手术过程中，患者自身的肺动脉瓣与肺动脉主干一起被切除，用于替换主动脉瓣。同种异体肺动脉移植物用于右心室流出道重建。1994年2月至2001年3月期间，第一心脏外科对43例14岁以上患者进行了Ross手术。平均年龄为24.9岁。手术指征主要为29例主动脉瓣狭窄、7例主动脉瓣关闭不全、7例复杂主动脉瓣疾病。医院死亡率为4.6%。中期观察时，41例患者存活。所有存活者均处于纽约心脏协会心功能I级，无并发症且无需药物治疗。所有患者的自体移植瓣膜功能良好（无反流或轻度反流）。所有患者左心室功能的超声心动图参数均有改善。青少年和成人肺动脉自体移植植入的指征为主动脉环较小、感染性心内膜炎以及抗凝剂使用的禁忌证。早期和中期结果证实Ross手术在该年龄组疗效高、死亡率低。它完全缓解了左心室的异常负荷状况，使左心室功能完全恢复。
