An expanded polytetrafluoroethylene-autologous aortic hybrid valve for right ventricular outflow tract reconstruction in the Ross procedure.
An expanded polytetrafluoroethylene-autologous aortic hybrid valve for right ventricular outflow tract reconstruction in the Ross procedure.
复制标题
一种扩张的聚四氟乙烯-自体主动脉混合瓣膜，用于罗斯手术中右心室流出道重建。
DOI：
10.1510/icvts.2006.143479
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发表时间：
2006
影响因子：
--
通讯作者：
H. Yaku
中科院分区：
文献类型：
--
作者：
Takako Miyazaki;M. Yamagishi;K. Shuntoh;H. Yaku
虽然Ross手术是治疗儿童和年轻人主动脉瓣疾病的成熟方法，但仍然没有理想的右心室流出道（RVOT）重建方法，特别是在儿童中。为了实现改善的RVOT重建，并具有长期瓣膜功能和生长潜力，我们开发了一种混合瓣膜，该瓣膜结合了自体主动脉瓣和膨体聚四氟乙烯（ePTFE）瓣膜。RVOT的后壁使用具有非冠状瓣尖的自体主动脉壁重建，前壁使用由牛心包或ePTFE制成的补片（带有二尖瓣ePTFE瓣膜）重建。我们在14例患者（年龄5-18岁）中植入了混合瓣膜。在随访期间（2.4-8.8年），无死亡或发病，无患者需要再次手术。超声心动图显示所有患者均无明显狭窄和返流，瓣膜运动正常。早期和晚期随访时肺动脉瓣环直径的z值分别为-1.4和-1.8，差异不显著。混合瓣膜的创建与极好的中长期结果相关。鉴于其理论上的生长潜力，我们推测该瓣膜可能是Ross手术中RVOT重建的良好选择，尤其是对于年幼儿童。
Although the Ross procedure is a well-established approach to aortic valve disease in pediatric patients and young adults, there still is no ideal method of right ventricular outflow tract (RVOT) reconstruction, especially in children. To achieve improved RVOT reconstruction with long-term valve function and growth potential, we have developed a hybrid valve which combines the autologous aortic valve and expanded polytetrafluoroethylene (ePTFE) valves. The posterior wall of RVOT was reconstructed using the autologous aortic wall with a noncoronary cusp, and the anterior wall was reconstructed using a patch made of bovine pericardium or ePTFE with bicuspid ePTFE valves. We implanted hybrid valves in 14 patients (age 5-18 years). During the follow-up period (2.4-8.8 years), there were no mortalities or morbidities, and no patients required reoperation. Echocardiography showed no significant stenosis and regurgitation, and preserved valve motion in all patients. The z-value of the diameters of the pulmonary annulus in early and late follow-up was -1.4 and -1.8, respectively, the difference not being significant. Creation of a hybrid valve was associated with excellent mid- to long-term results. Given its theoretical growth potential, we speculate that this valve could be a good choice for RVOT reconstruction in the Ross procedure, especially for young children.