Lentini S, Cartier P, Métras J, Cloutier A, Raymond G, Desaulniers D, Doyle D, Lemieux M
Service de Chirurgie Cardiaque, Institut de Cardiologie de Québec, Hôpital Laval, Canada.
Ann Chir. 1994;48(8):749-54.
The aortic stenosis represents 5% of all congenital cardiac pathology. The conventional treatments often do not give very satisfactory results. Since 1990, as alternative to the traditional aortic valve replacement, we used, in our institution, the Ross procedure (pulmonary autograft). This consists in using the pulmonary valve as an autograft in aortic position to replace the diseased valve. Then, the pulmonary outflow is reconstructed with a cryopreserved homograft. This study includes 15 patients, aged between 16 months and 18 years, treated with this technique since 1990. There has been no mortality. All the patients are alive at the follow-up, and all in NYHA functional class I. No reoperation has been necessary for valvular dysfunction. The post-operative doppler study at aortic level demonstrated those gradients: Mean + SD, 3.8 +/- 8.1 (range 0-23). No regurgitation haemodynamically important has been recorded at aortic level nor in the pulmonary position. Post-operative gradients at pulmonary level were: Mean + SD, 14.6 + 10.6 (range 14-32).
主动脉狭窄占所有先天性心脏疾病的5%。传统治疗方法往往不能取得非常令人满意的效果。自1990年以来，作为传统主动脉瓣置换术的替代方法，我们机构采用了罗斯手术（肺动脉自体移植术）。该手术包括将肺动脉瓣作为自体移植物置于主动脉位置以替换病变瓣膜。然后，用冷冻保存的同种异体移植物重建肺动脉流出道。本研究纳入了15例年龄在16个月至18岁之间、自1990年起接受该技术治疗的患者。无死亡病例。所有患者在随访时均存活，且心功能均为纽约心脏协会（NYHA）I级。无需因瓣膜功能障碍再次手术。主动脉水平的术后多普勒研究显示以下压差：平均值±标准差，3.8±8.1（范围0 - 23）。在主动脉水平及肺动脉位置均未记录到具有血流动力学意义的反流。肺动脉水平的术后压差为：平均值±标准差，14.6 + 10.6（范围14 - 32）。
