主動脈瓣成形術治療兒童主動脈瓣疾病 30 例_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

靳永強 , 李洪銀 , 薛輝 , 陳國良 , 張曉雅 ,  吳清玉

清華大學第一附屬醫院心臟中心（北京 100016）;

Corresponding?author：

吳清玉, Email: wuqingyu@mail.tsinghua.edu.cn

Keywords：

主動脈瓣成形; 兒童; 主動脈瓣狹窄; 主動脈瓣關閉不全

DOI：

10.7507/1007-4848.201812064

Video：

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目的總結我院用主動脈瓣成形術治療兒童主動脈瓣疾病的方法和結果。方法回顧性分析我院2005 年 1 月至 2017 年 12 月 30 例行主動脈瓣成形術患兒的臨床資料，其中男 17 例、女 13 例，年齡 4 個月～16 歲，平均年齡（6.7±4.3）歲，體重 5.6～62.4（23.7±14.1）kg。結果 30 例患者均存活，圍術期無嚴重并發癥，術后平均跨瓣壓差（21.1±17.0）mm Hg。隨訪 9 個月～13 年，共有 4 例患兒出現中度以上的主動脈瓣狹窄或關閉不全，其中 1 例行再次手術。其余患者瓣膜功能良好。結論主動脈瓣成形術安全可靠，近中期效果良好，少數患者仍需再次手術，可作為治療兒童主動脈瓣疾病的首選術式。

Citation： 靳永強, 李洪銀, 薛輝, 陳國良, 張曉雅, 吳清玉. 主動脈瓣成形術治療兒童主動脈瓣疾病 30 例. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(10): 1038-1041. doi: 10.7507/1007-4848.201812064 Copy

1.	陳寶田, 董然. 先天性主動脈瓣狹窄的外科治療. 心肺血管病雜志, 1997, 16(2): 121-123.
2.	Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol, 2010, 55(25): 2789-2800.
3.	Karamlou T, Jang K, Williams WG, et al. Outcomes and associated risk factors for aortic valve replacement in 160 children: a competing-risks analysis. Circulation, 2005, 112(22): 3462-3469.
4.	Chan V, Malas T, Lapierre H, et al. Reoperation of left heart valve bioprostheses according to age at implantation. Circulation, 2011, 124(11 Suppl): S75-S80.
5.	Jaquiss RD. Bioprosthetic aortic valve replacement in the young: a cautionary tale. Circulation, 2014, 130(1): 7-9.
6.	Goldstone AB, Chiu P, Baiocchi M, et al. Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement. N Engl J Med, 2017, 377(19): 1847-1857.
7.	Lababidi Z. Aortic balloon valvuloplasty. Am Heart J, 1983, 106(4 Pt 1): 751-752.
8.	Lababidi Z, Wu JR, Walls JT. Percutaneous balloon aortic valvuloplasty: results in 23 patients. Am J Cardiol, 1984, 53(1): 194-197.
9.	Pedra CA, Sidhu R, McCrindle BW, et al. Outcomes after balloon dilation of congenital aortic stenosis in children and adolescents. Cardiol Young, 2004, 14(3): 315-321.
10.	Ross DN. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet, 1967, 2(7523): 956-958.
11.	Elkins RC, Thompson DM, Lane MM, et al. Ross operation: 16-year experience. J Thorac Cardiovasc Surg, 2008, 136(3): 623-630.
12.	Pasquali SK, Cohen MS, Shera D, et al. The relationship between neo-aortic root dilation, insufficiency, and reintervention following the Ross procedure in infants, children, and young adults. J Am Coll Cardiol, 2007, 49(17): 1806-1812.
13.	Tan Tanny SP, Yong MS, d'Udekem Y, et al. Ross procedure in children: 17-year experience at a single institution. J Am Heart Assoc, 2013, 2(2): e000153.
14.	Schneider AW, Putter H, Klautz RJM, et al. Long-term follow-up after the Ross procedure: a single center 22-year experience. Ann Thorac Surg, 2017, 103(6): 1976-1983.
15.	David TE, Omran A, Ivanov J, et al. Dilation of the pulmonary autograft after the Ross procedure. J Thorac Cardiovasc Surg, 2000, 119(2): 210-220.
16.	Siddiqui J, Brizard CP, Konstantinov IE, et al. Outcomes after operations for bicuspid aortic valve disease in the pediatric population. Ann Thorac Surg, 2013, 96(6): 2175-2183.
17.	Al Halees Z, Al Shahid M, Al Sanei A, et al. Up to 16 years follow-up of aortic valve reconstruction with pericardium: a stentless readily available cheap valve? Eur J Cardiothorac Surg, 2005, 28(2): 200-205.
18.	d'Udekem Y, Siddiqui J, Seaman CS, et al. Long-term results of a strategy of aortic valve repair in the pediatric population. J Thorac Cardiovasc Surg, 2013, 145(2): 461-467.
19.	金晶, 華正東, 曾祥軍, 等. 單個主動脈瓣葉牛心包置換術治療兒童室間隔缺損并主動脈瓣反流. 中國胸心血管外科臨床雜志, 2014, 21(2): 216-219.

1. 陳寶田, 董然. 先天性主動脈瓣狹窄的外科治療. 心肺血管病雜志, 1997, 16(2): 121-123.
2. Siu SC, Silversides CK. Bicuspid aortic valve disease. J Am Coll Cardiol, 2010, 55(25): 2789-2800.
3. Karamlou T, Jang K, Williams WG, et al. Outcomes and associated risk factors for aortic valve replacement in 160 children: a competing-risks analysis. Circulation, 2005, 112(22): 3462-3469.
4. Chan V, Malas T, Lapierre H, et al. Reoperation of left heart valve bioprostheses according to age at implantation. Circulation, 2011, 124(11 Suppl): S75-S80.
5. Jaquiss RD. Bioprosthetic aortic valve replacement in the young: a cautionary tale. Circulation, 2014, 130(1): 7-9.
6. Goldstone AB, Chiu P, Baiocchi M, et al. Mechanical or biologic prostheses for aortic-valve and mitral-valve replacement. N Engl J Med, 2017, 377(19): 1847-1857.
7. Lababidi Z. Aortic balloon valvuloplasty. Am Heart J, 1983, 106(4 Pt 1): 751-752.
8. Lababidi Z, Wu JR, Walls JT. Percutaneous balloon aortic valvuloplasty: results in 23 patients. Am J Cardiol, 1984, 53(1): 194-197.
9. Pedra CA, Sidhu R, McCrindle BW, et al. Outcomes after balloon dilation of congenital aortic stenosis in children and adolescents. Cardiol Young, 2004, 14(3): 315-321.
10. Ross DN. Replacement of aortic and mitral valves with a pulmonary autograft. Lancet, 1967, 2(7523): 956-958.
11. Elkins RC, Thompson DM, Lane MM, et al. Ross operation: 16-year experience. J Thorac Cardiovasc Surg, 2008, 136(3): 623-630.
12. Pasquali SK, Cohen MS, Shera D, et al. The relationship between neo-aortic root dilation, insufficiency, and reintervention following the Ross procedure in infants, children, and young adults. J Am Coll Cardiol, 2007, 49(17): 1806-1812.
13. Tan Tanny SP, Yong MS, d'Udekem Y, et al. Ross procedure in children: 17-year experience at a single institution. J Am Heart Assoc, 2013, 2(2): e000153.
14. Schneider AW, Putter H, Klautz RJM, et al. Long-term follow-up after the Ross procedure: a single center 22-year experience. Ann Thorac Surg, 2017, 103(6): 1976-1983.
15. David TE, Omran A, Ivanov J, et al. Dilation of the pulmonary autograft after the Ross procedure. J Thorac Cardiovasc Surg, 2000, 119(2): 210-220.
16. Siddiqui J, Brizard CP, Konstantinov IE, et al. Outcomes after operations for bicuspid aortic valve disease in the pediatric population. Ann Thorac Surg, 2013, 96(6): 2175-2183.
17. Al Halees Z, Al Shahid M, Al Sanei A, et al. Up to 16 years follow-up of aortic valve reconstruction with pericardium: a stentless readily available cheap valve? Eur J Cardiothorac Surg, 2005, 28(2): 200-205.
18. d'Udekem Y, Siddiqui J, Seaman CS, et al. Long-term results of a strategy of aortic valve repair in the pediatric population. J Thorac Cardiovasc Surg, 2013, 145(2): 461-467.
19. 金晶, 華正東, 曾祥軍, 等. 單個主動脈瓣葉牛心包置換術治療兒童室間隔缺損并主動脈瓣反流. 中國胸心血管外科臨床雜志, 2014, 21(2): 216-219.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

主動脈瓣成形術治療兒童主動脈瓣疾病 30 例

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