초록접수 현황
| 16F-053 | 구연 발표 |
The Ross Procedure in Patients Aged Less than 18 Years: a 20-year Single-center Experience
Dong Woog Yoon, Ji-Hyuk Yang, Tae-Gook Jun, Pyo Won Park
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
Background : Due to hemodynamic performance and potential for growth of pulmonary autograft, the Ross/Ross-Konno procedure is considered to be a good option for irreparable aortic valve disease in pediatric patients. This study is a review of our long-term results of 20 year experience of Ross/Ross-Konno procedure in Samsung Medical Center.
Methods : Between June 1995 and January 2016, 16 consecutive patients (mean age 6.0 ± 5.9 years; range: 16 days to 17.4 years) underwent either a Ross procedrue (n = 9) or Ross-Konno procedure (n = 7). There were 12 males and 4 females. The median follow up period was 47 months (range: 6-256 months). The underlying aortic valve pathology was mainly congenital (n=15) and 1 patient with infective endocarditis. Among patients, 11 (69%) had undergone a previous aortic valve procedure. Concomitant procedures were performed in 12 patients (75%). All the patients underwent aortic root replacement with pulmonary autograft. And Ross-Konno procedure was performed with Konno annular enlargement using pulmonary autograft and conal septotomy.
Results : There was no hospital mortality and late mortality. In total, 6 reoperation were performed in 5 patients. Two patients underwent replacement of pulmonary autograft and RV-PA conduit replacement concomitantly, 10 years and 8 years after Ross operation, respectively. 4 patients underwent RV-PA conduit replacement. Freedom from reoperation of pulmonary autograft was 80% and 60% at 10 and 15 years. And freedom from valve-related reoperation was 78%, 62% and 52% at 5, 10 and 15 years, respectively.
Conclusion : Pulmonary autografts demonstrated good durability with low mortality. This study shows that Ross/Ross-Konno procedure can be a good choice and performed safely in pediatric patients with aortic valve disease, even in small volume center.
Methods : Between June 1995 and January 2016, 16 consecutive patients (mean age 6.0 ± 5.9 years; range: 16 days to 17.4 years) underwent either a Ross procedrue (n = 9) or Ross-Konno procedure (n = 7). There were 12 males and 4 females. The median follow up period was 47 months (range: 6-256 months). The underlying aortic valve pathology was mainly congenital (n=15) and 1 patient with infective endocarditis. Among patients, 11 (69%) had undergone a previous aortic valve procedure. Concomitant procedures were performed in 12 patients (75%). All the patients underwent aortic root replacement with pulmonary autograft. And Ross-Konno procedure was performed with Konno annular enlargement using pulmonary autograft and conal septotomy.
Results : There was no hospital mortality and late mortality. In total, 6 reoperation were performed in 5 patients. Two patients underwent replacement of pulmonary autograft and RV-PA conduit replacement concomitantly, 10 years and 8 years after Ross operation, respectively. 4 patients underwent RV-PA conduit replacement. Freedom from reoperation of pulmonary autograft was 80% and 60% at 10 and 15 years. And freedom from valve-related reoperation was 78%, 62% and 52% at 5, 10 and 15 years, respectively.
Conclusion : Pulmonary autografts demonstrated good durability with low mortality. This study shows that Ross/Ross-Konno procedure can be a good choice and performed safely in pediatric patients with aortic valve disease, even in small volume center.
책임저자: Tae-Gook Jun
Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
발표자: Dong Woog Yoon, E-mail : yoondw86@naver.com