PULMONARY AUTOGRAFT REPLACEMENT IN CHILDREN - THE IDEAL SOLUTION

被引：54

作者：

ELKINS, RC ^{[1
]}

SANTANGELO, K ^{[1
]}

RANDOLPH, JD ^{[1
]}

KNOTTCRAIG, CJ ^{[1
]}

STELZER, P ^{[1
]}

THOMPSON, WM ^{[1
]}

RAZOOK, JD ^{[1
]}

WARD, KE ^{[1
]}

OVERHOLT, ED ^{[1
]}

HARKEN, AH ^{[1
]}

SPENCER, FC ^{[1
]}

BENDER, HW ^{[1
]}

机构：

[1] LENOX HILL HOSP, NEW YORK, NY 10021 USA

来源：

ANNALS OF SURGERY | 1992年 / 216卷 / 03期

关键词：

D O I：

10.1097/00000658-199209000-00016

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

Fifty-one children, aged 1.8 to 21 years (mean, 11.4) with aortic valve replacement using a pulmonary autograft are reviewed. Twenty-nine were intra-aortic implants and 22 were root replacements. There was one operative death, no late deaths, and two have required reoperation. Actuarial freedom from reoperation was 93% +/- 5.5 at 5.6 years. Freedom from progression of aortic insufficiency (AI) was 81% +/- 9 at 5.6 years in the intra-aortic implants and 86% +/- 10 in the root replacement. Enlargement of the pulmonary autograft was seen echocardiographically in both groups. This enlargement was consistent with somatic growth and not associated with progression of AI. Ten of 19 patients with aortic stenosis had an LV mass index suggestive of LV hypertrophy before operation. At 1 year, 18 of 25 had a normal LV mass index. Thirteen of 16 patients with Al had preoperative abnormal LV mass index. All but four returned to normal by 1 year. Low operative risk, excellent function, resolution of abnormal LV hemodynamics, and enlargement consistent with somatic growth suggest that the pulmonary autograft is the ideal replacement for the malfunctioning aortic valve.

引用

页码：363 / 371

页数：9

共 32 条

[1] UNEXPECTED PERSISTENCE INTO ADULTHOOD OF LOW WALL STRESS IN PATIENTS WITH CONGENITAL AORTIC-STENOSIS - IS THERE A FUNDAMENTAL DIFFERENCE IN THE HYPERTROPHIC RESPONSE TO A PRESSURE OVERLOAD PRESENT FROM BIRTH [J].