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[两例先天性主动脉瓣狭窄患者成功施行肺动脉自体移植术(Ross手术)置换主动脉根部]

[Successful aortic root replacement with pulmonary autograft (Ross) in two cases of congenital aortic stenosis].

作者信息

Morita K, Kurosawa H, Takakura H, Miyamoto H, Ishii S, Kanazawa T

机构信息

Jikei University School of Medicine, Cardiac Surgery, Tokyo, Japan.

出版信息

Nihon Kyobu Geka Gakkai Zasshi. 1997 Apr;45(4):594-600.

PMID:9155131
Abstract

Two cases of 7 and 23 year of age with congenital aortic stenosis associated with the small valve annulus underwent successful aortic root replacement with pulmonary autograft (Ross procedure). Preoperative pressure gradient and the valve size were 120 and 80 mmHg, and 16 and 18 mm, respectively. Even with the small native aortic annulus, pulmonary autografts could be implanted to aortic annulus without autograft distortion by the method of total aortic replacement. The right ventricular outflow reconstruction was performed with PTFE-valved bovine pericardial conduit with securing the posterior muscular edge by a strip of autologous aortic wall. Postoperative course in both patients was uneventful without any rhythm disturbances. During the 12 and 14 months of follow-up, both patients were in excellent clinical condition with no evidence of autograft valve regurgitation and functional deterioration of valved conduit. This procedure was thought to be a preferable method of young cases with congenital aortic stenosis.

摘要

两例分别为7岁和23岁的先天性主动脉瓣狭窄合并小瓣环患者成功接受了自体肺动脉移植主动脉根部置换术(Ross手术)。术前压力阶差和瓣膜大小分别为120 mmHg和80 mmHg,以及16 mm和18 mm。即使自体主动脉瓣环较小,通过全主动脉置换的方法,也可将自体肺动脉移植到主动脉瓣环而不出现移植物扭曲。采用带PTFE瓣膜的牛心包管道进行右心室流出道重建,并使用一条自体主动脉壁条固定后肌缘。两名患者术后病程平稳,无任何节律紊乱。在12个月和14个月的随访期间,两名患者临床状况良好,无自体移植瓣膜反流及带瓣管道功能恶化的迹象。该手术被认为是先天性主动脉瓣狭窄年轻患者的一种较好治疗方法。

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