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find Keyword "Konno 手术" 2 results
  • Ross-Konno 手术治疗儿童主动脉瓣及瓣下狭窄的临床疗效

    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。

    Release date:2020-04-26 03:44 Export PDF Favorites Scan
  • Mid- and long-term results of different techniques for subaortic stenosis

    ObjectiveTo evaluate the mid- and long-term outcomes of different surgical techniques for subaortic stenosis.MethodsThe clinical data of 75 patients with subaortic stenosis who underwent surgery in our hospital from January 2008 to January 2018 were retrospectively analyzed, including 48 males and 27 females, with a median age of 72 (48, 132) months and mean weight of 21.35±15.82 kg. There were 40 (53.3%) patients combined with aortic regurgitation; 38 (50.7%) patients were the first time and 37 patients were the second time to receive the operation. According to the surgical techniques, 75 patients were divided into two groups: a group A (40 patients with simple subaortic membrane resection) and a group B (35 patients with subaortic membrane and muscle resection or modified Konno procedure).ResultsTwo (2.67%) patients died in hospital. There was one late death in the group B. The average preoperative and postoperative pressure gradient of all patients was 69.96±42.02 mm Hg and 7.44±12.45 mm Hg, respectively. All patients were followed up for 51 (12, 120) months. Pressure gradient at follow-up in the group A and the group B was 8.83±14.52 mm Hg and 5.86±9.53 mm Hg, respectively with no statistical difference (P=0.294). Four patients in the group A and 2 patients in the group B needed reintervention. However, there was no statistical difference in the long-term reintervention rate between the two groups (P=0.480).ConclusionFor the different degree of lesions in the left ventricular outflow tract, our management strategy is feasible. Although there is no statistical difference between two the groups in the long-term reintervention rate after simple valvular membrane resection, prolonged follow-up is necessary to examine the long-term outcomes of different surgical techniques.

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