Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Mid-term Results of the Ross Procedure

Ross 술식의 중단기 성적

  • Kang Seong-Sik (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan) ;
  • Jung Sung-Ho (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan) ;
  • Lee Sang-Gwon (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan) ;
  • Joo Suk-Jung (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan) ;
  • Song Hyun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan) ;
  • Song Meong-Gun (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan) ;
  • Lee Jae-Won (Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan)
  • 강성식 (울산대학교 서울아산병원 흉부외과) ;
  • 정성호 (울산대학교 서울아산병원 흉부외과) ;
  • 이상권 (울산대학교 서울아산병원 흉부외과) ;
  • 주석중 (울산대학교 서울아산병원 흉부외과) ;
  • 송현 (울산대학교 서울아산병원 흉부외과) ;
  • 송명근 (울산대학교 서울아산병원 흉부외과) ;
  • 이재원 (울산대학교 서울아산병원 흉부외과)
  • Published : 2005.01.01
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Abstract

Ross procedure is ideal aortic valve replacement method with several merits of hemodynamic superiority and durability without the need of anticoagulation. Based upon this presumption, we studied its procedure performed in our hospital and tried to get the mid-term results Material and Method: From Jan 1999 to Oct 2001, 22 patients underwent the Ross procedure. The mean age of experimented (including 17 men and 5 women) was $30.9{\pm}8.1(17\~44)$. The diagnosis before the surgery had shown 20 as accompanied with AR and the rest 2 as with ASR. The follow-up period ranged from 0.6 to 40.6 months, mean of $38.9{\pm}1.6\;months,\;and\;follow-up\;rate\;was\;100{\%}$. Result. There was no operative death and two late deaths, one of whom was cardiac originated and the other, non-cardiac relate The survival rate was $94.1{\pm}5.7{\%}$(40.6 months). Postoperatively there were 2 exploration for bleeding, 3 low cardiac output patients. The pulmonary autograft technique was root replacement in 14 and inclusion technique in 8. Pulmonary homografts were used at the pulmonary position in all cases. There was no patient with significant aortic regurgitation. Conclusion: These showed that the mortality and morbidity of the Ross procedure were acceptable and postoperative AR was not significant. However, further long-term follow-up will be necessary for the improvement of the function of pulmonary autograft and homograft.

Ross 술식은 항응고제의 사용이 필요 없으며, 혈역학적으로 우수하고 내구성이 좋아 대동맥판막 치환술의 이상적인 방법으로 생각되고 있다. 이에 저자들은 본원에서 시행된 Ross 술식의 결과를 조사하여 중-단기 성적을 알아보고자 하였다. 대상 및 방법: 본원에서 1999년 1월부터 2001년 10월까지 Ross 술식을 시행 받은 22명을 대상으로 후향적으로 조사하였다. 환자의 평균 나이는 $30.9{\pm}8.1$세 $(17\~44)$였고, 수술 전 진단은 대동맥 판막 폐쇄부전증이 20명, 협착증과 부전증이 동반된 경우가 2명이었다. 평균 추적관찰 기간은 $38.9{\pm}1.6$개월이었고, 추적 관찰률은 $100{\%}$였다. 결과: 수술 사망은 없었고, 만기 사망은 2명이었는데 심장질환과 관련된 사망은 1명, 나머지 1명은 다른 원인이었다. 수술과 관련된 생존율은 40.6개월에 $94.1{\pm}5.7{\%}$를 보였다. 수술의 합병증으로는 출혈이 2명, 저심박출증이 3명 있었다. 자가 폐동맥 판막의 이식방법은 근위부 치환술이 14예, inclusion technique이 8예였다. 폐동맥 판막 치환술은 모두 동종 페동맥판막을 이용하였다. 추적 관찰하는 과정에서 중증도 이상의 대동맥 판막 폐쇄 부전증 환자는 없었다. 결론: 본원의 연구 결과 Ross술식의 수술 사망률이나 이환률은 좋은 성적을 보였으나 신대동맥 판막과 폐동맥 동종 판막에 대해서는 앞으로 장기적인 관찰이 필요할 것으로 생각된다.

Keywords

References

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