Marino Bradley S, Pasquali Sara K, Wernovsky Gil, Bockoven John R, McBride Michael, Cho Catherine J, Spray Thomas L, Paridon Stephen M
Division of Cardiology, at the Cardiac Center of The Children's Hospital of Philadelphia, and the Department of Pediatrics at the University of Pennsylvania School of Medicine 19104, USA.
Cardiol Young. 2006 Feb;16(1):40-7. doi: 10.1017/S1047951105002076.
The Ross procedure is increasingly utilized in the treatment of aortic valvar disease in children and adolescents. Our purpose was to compare pre- and post-operative exercise state in this population.
We included patients who underwent the Ross procedure at our institution between January, 1995, and December, 2003, and in whom we had performed pre- and post-operative exercise stress tests. We used a ramp bicycle protocol to measure consumption of oxygen and production of carbon dioxide. Cardiac output was estimated from effective pulmonary blood flow by the helium acetylene re-breathing technique.
We studied 26 patients, having a median age at surgery of 15.7 years, with a range from 7.5 to 24.1 years. The primary indication for surgery in two-thirds was combined aortic stenosis and insufficiency. Median time from the operation to the post-operative exercise stress test was 17.4 months, with a range from 6.7 to 30.2 months. There was a trend toward lower maximal consumption of oxygen after the procedure, at 36.3 plus or minus 7.6 millilitres per kilogram per minute (83.9% predicted) as opposed to 38.6 plus or minus 8.4 millilitres per kilogram per minute (88.5% predicted, p equal to 0.06). Patients after the procedure, however, had significantly increased adiposity, so that there was no difference in maximal consumption of oxygen indexed to ideal body weight before and after the operation. In 20 of the patients, aerobic capacity improved or was stable after the operation. There was no post-operative chronotropic impairment.
In the majority of patients following the Ross procedure, exercise performance is stable and within the normal range of a healthy age and sex matched population, despite sedentary lifestyles and increased adiposity.
罗斯手术越来越多地用于治疗儿童和青少年的主动脉瓣疾病。我们的目的是比较该人群手术前后的运动状态。
我们纳入了1995年1月至2003年12月在我们机构接受罗斯手术且术前后均进行了运动负荷试验的患者。我们采用斜坡式自行车运动方案来测量氧气消耗和二氧化碳产生。通过氦乙炔再呼吸技术根据有效肺血流量估算心输出量。
我们研究了26例患者，手术时的中位年龄为15.7岁，范围为7.5至24.1岁。三分之二患者的主要手术指征是主动脉瓣狭窄合并关闭不全。从手术到术后运动负荷试验的中位时间为17.4个月，范围为6.7至30.2个月。术后最大氧气消耗量有降低趋势，为每分钟每千克36.3±7.6毫升（预测值的83.9%），而术前为每分钟每千克38.6±8.4毫升（预测值的88.5%，p = 0.06）。然而，术后患者的肥胖显著增加，因此按理想体重计算的最大氧气消耗量在手术前后无差异。20例患者术后有氧能力改善或稳定。术后无变时性功能障碍。
在大多数接受罗斯手术的患者中，尽管生活方式久坐且肥胖增加，但运动表现稳定，处于健康的年龄和性别匹配人群的正常范围内。
