Pergola Valeria, Di Salvo Giovanni, Fadel Bahaa, Galzerano Domenico, Al-Shaid Maye, Al-Admawi Mohammad, Al Amri Mohammed, Al-Ahmadi Mamdouh, Al-Halees Zohair
The Heart Centre, King Faisal Specialist Hospital and research centre, Riyadh, Saudi Arabia.
The Heart Centre, King Faisal Specialist Hospital and research centre, Riyadh, Saudi Arabia.
Int J Cardiol. 2020 Dec 1;320:35-41. doi: 10.1016/j.ijcard.2020.07.009. Epub 2020 Jul 15.
The Ross procedure has been considered in children as an optimal surgical procedure due to potential growth of the aortic annulus, lack of anticoagulation requirement, very low morbidity rate and excellent survival. Five-hundred-thirty-six (366 male, mean age 29.4 ± 11.1 years) underwent Ross procedure between 1990 and 2016 and had complete clinical and echocardiographic follow-up. Mean follow-up was 16.3 ± 4.9 years. Patients were divided in 2 groups according to age at surgery. Group 1 consisted of 320 (60%) patients less than 18 years old (223 male, mean age at surgery of 9.5 ± 5.6 years). Group 2 consisted of 216 (40%) patients older than 18 years of age (143 male, mean age at surgery of 26.3 ± 8.2 years). One-hundred-thirty (24%) patients had a redo procedure or surgery. Freedom from all re-operation and or percutaneous reintervention on either the aortic and pulmonary valves was 99% after 1 year, 94% after 5 years, 89% after 10 years, 83% after 15 years and 78% after 20 years. Freedom from redo surgery for AV 99% after 1 year, 94% after 5 years, 90% after 10 years, 81% after 15 years and 80% after 20 years. Freedom from redo surgery for PV was 100% after 1 year, 95% after 5 years, 89% after 10 years, 78% after 15 years and 76% after 20 years. The ideal candidate for Ross operation is a patient with congenital aetiology and an aortic root diameter ≤ 15 mm/m. A pulmonary fresh preserved homograft seems to perform better on the long term.
由于主动脉瓣环具有潜在生长能力、无需抗凝、发病率极低且生存率高，罗斯手术被认为是儿童的最佳手术方式。1990年至2016年间，536例患者（366例男性，平均年龄29.4±11.1岁）接受了罗斯手术，并进行了完整的临床和超声心动图随访。平均随访时间为16.3±4.9年。根据手术时的年龄将患者分为两组。第1组包括320例（60%）年龄小于18岁的患者（223例男性，手术时平均年龄为9.5±5.6岁）。第2组包括216例（40%）年龄大于18岁的患者（143例男性，手术时平均年龄为26.3±8.2岁）。130例（24%）患者进行了再次手术或再次干预。主动脉瓣和肺动脉瓣免于再次手术和经皮再次干预的比例在1年后为99%，5年后为94%，10年后为89%，15年后为83%，20年后为78%。主动脉瓣再次手术的免于率在1年后为99%，5年后为94%，10年后为90%，15年后为81%，20年后为80%。肺动脉瓣再次手术的免于率在1年后为100%，5年后为95%，10年后为89%，15年后为78%，20年后为76%。罗斯手术的理想候选人是病因先天性且主动脉根部直径≤15mm/m的患者。新鲜保存的肺动脉同种异体移植物长期效果似乎更好。
