Kabbani Sami S, Sabbagh Nada A, Kudsi Abir Y, Nabhani Fawzi, Jamil Hisham
Damascus University Cardiovascular Surgical Center Mezzah, Damascus, Syria.
Asian Cardiovasc Thorac Ann. 2011 Jun;19(3-4):253-9. doi: 10.1177/0218492311409631.
Between July 1997 and August 2004, 92 patients with irreparable mitral valves underwent replacement with a pulmonary autograft. This report brings the follow-up data of these patients up to date. Eighty-eight patients had a successful Ross II operation; 4 were lost to follow-up. The mean follow-up period was 94 months. Transesophageal echocardiography revealed a successful outcome in all 88 patients immediately after the operation. Operative mortality was 4.6%, and late mortality definitely related to the operation was 12.5%. At a mean follow-up of 94 months, freedom from structural valve deterioration (significant mitral stenosis and/or regurgitation) was 93.4%, freedom from reoperation was 92.0%, and freedom from all causes of death was 82.9%. Two autografts were explanted because of endocarditis. Two patients developed significant pulmonary stenosis, one of whom underwent operative repair. These data compare favorably with those of mitral valve replacement using modern bioprostheses. This procedure remains an option for the relatively young patient when life-long anticoagulation is contraindicated or impractical. It is also an option to consider in infants with complex irreparable mitral valve disease.
1997年7月至2004年8月期间，92例二尖瓣无法修复的患者接受了自体肺动脉瓣置换术。本报告更新了这些患者的随访数据。88例患者成功接受了Ross II手术；4例失访。平均随访时间为94个月。经食管超声心动图显示，所有88例患者术后即刻结果均成功。手术死亡率为4.6%，与手术明确相关的晚期死亡率为12.5%。在平均94个月的随访中，无结构性瓣膜退变（严重二尖瓣狭窄和/或反流）的比例为93.4%，无需再次手术的比例为92.0%，无任何原因死亡的比例为82.9%。两枚自体瓣膜因心内膜炎被取出。两名患者出现严重肺动脉狭窄，其中一名接受了手术修复。这些数据与使用现代生物假体进行二尖瓣置换的数据相比具有优势。当终身抗凝禁忌或不切实际时，该手术仍是相对年轻患者的一种选择。对于患有复杂二尖瓣无法修复疾病的婴儿，这也是一种可考虑的选择。
