Bechtel J F, Sievers H-H
Klinik für Herzchirurgie, Universität zu Lübeck.
Dtsch Med Wochenschr. 2005 Mar 24;130(12):669-74. doi: 10.1055/s-2005-865078.
Young adults who have to undergo aortic valve surgery will frequently have (relative) contraindications to oral anticoagulation therapy because either pregnancy is planned or their life-style is very active. This review focuses on the surgical options available and assesses the literature focusing on the experience with each option obtained in young adults. There are no randomized studies in this age group which compare mechanical aortic valve replacement with any alternative option with regard to survival, need for reoperation, or quality of life. Among the alternative techniques, the Ross-procedure (pulmonary autograft) and aortic valve repair are of special interest. With the Ross-procedure, there is a rather large experience in young adults, and the results up to 10 years postoperatively are excellent. Unfortunately, there is only limited experience with this technique beyond that time.
必须接受主动脉瓣手术的年轻成年人,由于计划怀孕或生活方式非常活跃,往往(相对)存在口服抗凝治疗的禁忌证。本综述重点关注现有的手术选择,并评估有关在年轻成年人中获得的每种选择经验的文献。在这个年龄组中,没有随机研究比较机械主动脉瓣置换术与任何替代选择在生存、再次手术需求或生活质量方面的差异。在替代技术中,Ross手术(肺动脉自体移植)和主动脉瓣修复特别受关注。对于Ross手术,在年轻成年人中有相当丰富的经验,术后长达10年的结果非常好。不幸的是,超过这个时间后,该技术的经验有限。