Franke Ulrich F W, Ursulescu Adrian, Göbel Nora, Nagib Ragi, Hansen Matthias, Yadav Rashmi, Baumbach Hardy, Albert Marc
J Heart Valve Dis. 2015 May;24(3):295-301.
Based on superior long-term results, an increasing interest in the Ross procedure for young adult patients can be observed. After the first publication of this challenging procedure through a minimally invasive access, this operation has become an alternative to conventional sternotomy at the authors' department. This analysis compares the results and quality of life of the conventional and the minimally invasive Ross procedures.
By April 2013, a total of 136 patients had undergone the Ross procedure at the authors' institution. Preoperative parameters did not differ between the conventional group (C-group; n = 58; mean age 49 years) and the minimally invasive group (M-group; n = 78; mean age 50 years). Only the aortic cross-clamp time was longer for the M-group (151 versus 140 min).
One C-group patient died on the day of operation. Consecutively, survival was 99% for the follow up period of 1,093 ± 601 days. Valve-related reoperations were necessary for four patients. One C-group patient developed a distal pulmonary stenosis due to fibrotic scar tissue. Two M-group patients showed fistulas after early endocarditis, but the native valves could be preserved in these cases. One C-group patient with recurrent severe aortic regurgitation showed holes in two of three cusps. The SF-36 questionnaire detected better physical parameters (physical function, physical role function) for patients after minimally invasive access.
The minimally invasive Ross procedure allows the same excellent clinical outcome as the conventional technique. However, the physical quality of life is better with the minimally invasive procedure, in addition to an improved cosmetic result.
基于卓越的长期效果，可观察到年轻成年患者对罗斯手术的兴趣日益增加。在通过微创入路首次发表这一具有挑战性的手术后，该手术已成为作者所在科室传统胸骨切开术的替代方案。本分析比较了传统罗斯手术与微创罗斯手术的结果及生活质量。
截至2013年4月，作者所在机构共有136例患者接受了罗斯手术。传统组（C组；n = 58；平均年龄49岁）和微创组（M组；n = 78；平均年龄50岁）的术前参数无差异。仅M组的主动脉阻断时间较长（151分钟对140分钟）。
1例C组患者在手术当天死亡。随后，在1093±601天的随访期内生存率为99%。4例患者需要进行瓣膜相关再次手术。1例C组患者因纤维化瘢痕组织出现远端肺动脉狭窄。2例M组患者在早期心内膜炎后出现瘘管，但在这些病例中可保留自身瓣膜。1例复发性严重主动脉瓣反流的C组患者在三个瓣叶中的两个出现孔洞。SF - 36问卷显示，微创入路术后患者的身体参数（身体功能、身体角色功能）更佳。
微创罗斯手术与传统技术具有相同优异的临床效果。然而，除了改善美容效果外，微创技术的身体生活质量更佳。
