Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的临床疗效_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

邹明晖 , 马力 , 夏园生 , 杨盛春 , 陈伟丹 , 李文雷 ,  陈欣欣

广州医科大学附属广州市妇女儿童医疗中心心脏中心（广州 510623）;

Corresponding author：

陈欣欣, Email: zingerchen@163.com

Keywords：

Ross 手术; Konno 手术; 主动脉瓣狭窄; 主动脉瓣下狭窄; 早期结果

DOI：

10.7507/1007-4848.201912092

Video：

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目的评价 Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的早期临床疗效。方法 2018 年 12 月至 2019 年 12 月，共 12 例患儿因主动脉瓣及瓣下狭窄在我科接受手术治疗，其中男 8 例、女 4 例，接受手术时中位年龄 4 岁（11 个月～12 岁）。Ross-Konno 手术 11 例，单纯 Ross 手术 1 例。主动脉瓣重度狭窄 8 例，主动脉瓣关闭不全 2 例，狭窄合并关闭不全 2 例。合并主动脉二瓣化畸形 6 例，瓣下流出道显著狭窄 4 例，合并二尖瓣病变 4 例，合并弓部病变 3 例。手术采用自体肺动脉带瓣管道移植于主动脉瓣位，同期采用 Konno 法扩大左室流出道。采用牛颈静脉或带瓣 Gore-tex 人工血管重建右室流出道，并同期矫治心内合并畸形。所有患者均经多普勒彩色超声心动图定期进行随访评估。结果全组无手术死亡。术后中位随访时间 5.5（1～12）个月，1 例患儿残余左室流出道中度狭窄，其余患儿无显著左室流出道残余梗阻或复发梗阻，无新主动脉瓣显著反流。1 例患儿肺动脉带瓣管道主干中度狭窄，余重建右室流出道血流通畅，无明显瓣膜反流及赘生物形成。结论对于不适合瓣膜成形或置换术的儿童主动脉瓣膜病变，Ross-Konno 手术早期结果满意。

Citation： 邹明晖, 马力, 夏园生, 杨盛春, 陈伟丹, 李文雷, 陈欣欣. Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的临床疗效. 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, Bökenkamp 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, Bökenkamp 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 手术治疗儿童主动脉瓣及瓣下狭窄的临床疗效

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