Tsaroev Bashir, Chernov Igor, Enginoev Soslan, Mustaev Muslim
Federal State Budgetary Institution "Federal Center for Cardiovascular Surgery" of the Ministry of Health of the Russian Federation, Astrakhan, Astrakhan Region, Russia.
Department of Vascular Surgery, Alexandro-Mariinsky Regional Clinical Hospital, Astrakhan, Astrakhan Region, Russia.
JTCVS Open. 2022 Apr 21;10:140-147. doi: 10.1016/j.xjon.2022.04.026. eCollection 2022 Jun.
To evaluate our 12-year experience with the Ross procedure in adults.
A retrospective analysis of 215 cases of the Ross procedure was performed. The mean age of the patients was 36 ± 11.1 years, and the male to female ratio was 75% to 25%, respectively. The pulmonary autograft was placed into the aortic position using the full-root replacement technique and its modified versions. The right ventricular outflow tract was reconstructed using a pulmonary homograft in all cases.
The 30-day mortality after the operation was 0.9% (2 patients). The median duration of follow-up was 6.1 years (interquartile range, 6.5 years) and was complete in 86% of cases. The survival at 12 years was 94.7% and was comparable with the survival rate of the general population matched for age and sex. At the end of the follow-up, freedom from reoperation due to pulmonary autograft and homograft dysfunction was 89.1% and 99%, respectively.
In our series, the Ross procedure resulted in low early mortality and excellent survival in adults. The long-term survival was not statistically different from the survival of the general population. The pulmonary homograft offered an excellent durability and freedom from reoperation.
评估我们在成人中开展罗斯手术的12年经验。
对215例罗斯手术病例进行回顾性分析。患者的平均年龄为36±11.1岁，男女比例分别为75%和25%。采用全根置换技术及其改良术式将自体肺动脉瓣置于主动脉位置。所有病例均使用同种异体肺动脉瓣重建右心室流出道。
术后30天死亡率为0.9%（2例患者）。随访的中位时间为6.1年（四分位间距为6.5年），86%的病例随访完整。12年生存率为94.7%，与年龄和性别匹配的普通人群生存率相当。随访结束时，因自体肺动脉瓣和同种异体肺动脉瓣功能障碍而再次手术的免再手术率分别为89.1%和99%。
在我们的系列研究中，罗斯手术在成人中导致较低的早期死亡率和良好的生存率。长期生存率与普通人群的生存率无统计学差异。同种异体肺动脉瓣具有出色的耐久性和免再手术率。
