Ross-Konno 手術治療兒童主動脈瓣及瓣下狹窄的臨床療效_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

鄒明暉 , 馬力 , 夏園生 , 楊盛春 , 陳偉丹 , 李文雷 ,  陳欣欣

廣州醫科大學附屬廣州市婦女兒童醫療中心心臟中心（廣州 510623）;

Corresponding?author：

陳欣欣, Email: zingerchen@163.com

Keywords：

Ross 手術; Konno 手術; 主動脈瓣狹窄; 主動脈瓣下狹窄; 早期結果

DOI：

10.7507/1007-4848.201912092

Video：

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目的評價 Ross-Konno 手術治療兒童主動脈瓣及瓣下狹窄的早期臨床療效。方法 2018 年 12 月至 2019 年 12 月，共 12 例患兒因主動脈瓣及瓣下狹窄在我科接受手術治療，其中男 8 例、女 4 例，接受手術時中位年齡 4 歲（11 個月～12 歲）。Ross-Konno 手術 11 例，單純 Ross 手術 1 例。主動脈瓣重度狹窄 8 例，主動脈瓣關閉不全 2 例，狹窄合并關閉不全 2 例。合并主動脈二瓣化畸形 6 例，瓣下流出道顯著狹窄 4 例，合并二尖瓣病變 4 例，合并弓部病變 3 例。手術采用自體肺動脈帶瓣管道移植于主動脈瓣位，同期采用 Konno 法擴大左室流出道。采用牛頸靜脈或帶瓣 Gore-tex 人工血管重建右室流出道，并同期矯治心內合并畸形。所有患者均經多普勒彩色超聲心動圖定期進行隨訪評估。結果全組無手術死亡。術后中位隨訪時間 5.5（1～12）個月，1 例患兒殘余左室流出道中度狹窄，其余患兒無顯著左室流出道殘余梗阻或復發梗阻，無新主動脈瓣顯著反流。1 例患兒肺動脈帶瓣管道主干中度狹窄，余重建右室流出道血流通暢，無明顯瓣膜反流及贅生物形成。結論對于不適合瓣膜成形或置換術的兒童主動脈瓣膜病變，Ross-Konno 手術早期結果滿意。

Citation： 鄒明暉, 馬力, 夏園生, 楊盛春, 陳偉丹, 李文雷, 陳欣欣. Ross-Konno 手術治療兒童主動脈瓣及瓣下狹窄的臨床療效. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2020, 27(4): 476-478. doi: 10.7507/1007-4848.201912092 Copy

1.	Mavroudis C, Mavroudis CD, Jacobs JP. The Ross, Konno, and Ross-Konno operations for congenital left ventricular outflow tract abnormalities. Cardiol Young, 2014, 24(6): 1121-1133.
2.	Hraska V, Photiadis J, Poruban R, et al. Ross-Konno operation in children. Multimed Man Cardiothorac Surg, 2008, 915: mmcts. 2008. 003160.
3.	Zimmermann C, Attenhofer Jost C, Prêtre R, et al. Mid-term outcome of 100 consecutive Ross procedures: excellent survival, but yet to be a cure. Pediatr Cardiol, 2018, 39(3): 595-603.
4.	Schneider AW, B?kenkamp R, Bruggemans EF, et al. Twenty-year experience with the Ross-Konno procedure. Eur J Cardiothorac Surg, 2016, 49(6): 1564-1570.
5.	Ruzmetov M, Geiss DM, Shah JJ, et al. The Ross-Konno is a high-risk procedure when compared with the Ross operation in children. Ann Thorac Surg, 2013, 95(2): 670-675.
6.	Sames-Dolzer E, Wickenhauser E, Kreuzer M, et al. The Ross-Konno procedure in neonates and infants less than 3 months of age. Eur J Cardiothorac Surg, 2018, 54(1): 71-77.
7.	Aszyk P, Thiel C, Sinzobahamvya N, et al. Ross-Konno procedure in infants: mid-term results. Eur J Cardiothorac Surg, 2012, 42(4): 687-694.
8.	Schneider AW, Putter H, Klautz RJM, et al. Long-term follow-up after the ross procedure: a single center 22-year experience. Ann Thorac Surg, 2017, 103(6): 1976-1983.
9.	Lo Rito M, Davies B, Brawn WJ, et al. Comparison of the Ross/Ross-Konno aortic root in children before and after the age of 18 months. Eur J Cardiothorac Surg, 2014, 46(3): 450-457.
10.	Matsuzaki Y, Hiramatsu T, Agematsu K, et al. Long-term outcomes of Ross and Ross-Konno operations in patients under 15 years of age. Gen Thorac Cardiovasc Surg, 2019, 67(5): 420-426.

1. Mavroudis C, Mavroudis CD, Jacobs JP. The Ross, Konno, and Ross-Konno operations for congenital left ventricular outflow tract abnormalities. Cardiol Young, 2014, 24(6): 1121-1133.
2. Hraska V, Photiadis J, Poruban R, et al. Ross-Konno operation in children. Multimed Man Cardiothorac Surg, 2008, 915: mmcts. 2008. 003160.
3. Zimmermann C, Attenhofer Jost C, Prêtre R, et al. Mid-term outcome of 100 consecutive Ross procedures: excellent survival, but yet to be a cure. Pediatr Cardiol, 2018, 39(3): 595-603.
4. Schneider AW, B?kenkamp R, Bruggemans EF, et al. Twenty-year experience with the Ross-Konno procedure. Eur J Cardiothorac Surg, 2016, 49(6): 1564-1570.
5. Ruzmetov M, Geiss DM, Shah JJ, et al. The Ross-Konno is a high-risk procedure when compared with the Ross operation in children. Ann Thorac Surg, 2013, 95(2): 670-675.
6. Sames-Dolzer E, Wickenhauser E, Kreuzer M, et al. The Ross-Konno procedure in neonates and infants less than 3 months of age. Eur J Cardiothorac Surg, 2018, 54(1): 71-77.
7. Aszyk P, Thiel C, Sinzobahamvya N, et al. Ross-Konno procedure in infants: mid-term results. Eur J Cardiothorac Surg, 2012, 42(4): 687-694.
8. Schneider AW, Putter H, Klautz RJM, et al. Long-term follow-up after the ross procedure: a single center 22-year experience. Ann Thorac Surg, 2017, 103(6): 1976-1983.
9. Lo Rito M, Davies B, Brawn WJ, et al. Comparison of the Ross/Ross-Konno aortic root in children before and after the age of 18 months. Eur J Cardiothorac Surg, 2014, 46(3): 450-457.
10. Matsuzaki Y, Hiramatsu T, Agematsu K, et al. Long-term outcomes of Ross and Ross-Konno operations in patients under 15 years of age. Gen Thorac Cardiovasc Surg, 2019, 67(5): 420-426.

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Ross-Konno 手術治療兒童主動脈瓣及瓣下狹窄的臨床療效

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