Ross Procedure(罗斯程序)研究综述
Ross Procedure 罗斯程序 - According to the results of modern researchers, the main techniques used in congenital pathology of the aortic valve in children include balloon catheter dilatation of the aortic valve, surgical valvuloplasty, the Ross procedure and replacement of the aortic valve with a mechanical prosthesis. [1] The articles address (1) developing a risk score to predict adverse outcomes in patients with hypoplastic left heart syndrome using the national pediatric cardiology quality improvement collaborative, (2) outcomes of the Ross procedure in patients with a previous aortic valve surgery showing better outcomes in these patients compared to patients with the primary Ross procedure, (3) the initial experience with continuous flow ventricular assist devices in pediatric patients showing low mortality post implantation, (4) lower socioeconomic status is associated with worse long-term neurodevelopmental outcomes in patients with hypoplastic left heart syndrome, (5) QRS fragmentation is associated with higher incidence of appropriate shock after implantable cardioverter defibrillator implantation in repaired tetralogy of Fallot, (6) atrioventricular valve repair may have better outcomes if performed before the Fontan operation compared to after the Fontan operation. [2] We also tested the variability of the measured lead concentration across procedures and spotted blood volumes and found no significant additions to uncertainty in measurements. [3] Method performance was evaluated across procedure volume terciles: small ( 171). [4] Young patients might benefit from a Ross procedure in such a scenario, provided it can be performed safely and with adequate durability. [5] We found inconsistencies in risk preferences elicited across procedures. [6] We sought to determine the differences in HRQOL following AVR with either the Ross procedure or mechanical AVR in this young population. [7] Multicenter data supporting use of the Ross procedure with respect to long-term postoperative valve-related mortality and reintervention, as well as function of the autograft and pulmonary homograft, are needed. [8] OBJECTIVE To compare outcomes with wrapped (pulmonary autograft inclusion) versus unwrapped techniques in adults with bicuspid aortic valves undergoing the Ross procedure. [9] Autograft failure following the favoured Ross procedure deemed the patient as a candidate for an Ozaki procedure. [10] Although the magnitude of effects varied, these trends were similar across procedure subgroups. [11] OBJECTIVE Difficult to repair aortic valve lesions, requiring the use of a valve substitute, remain controversial in the face of the Ross procedure, despite undeniable technical advances. [12] Overall, RFID tracking represents a scalable, systematic, and efficient method of optimizing instrument supply across procedures. [13] Background: We sought to evaluate the outcomes following right ventricle to pulmonary artery (RV-PA) conduit placement in pediatric patients, excluding those with a RV-PA conduit for the Ross procedure which is associated with improved conduit durability, partly related to its orthotopic position. [14] Twenty children were included in this study, 10 after Ozaki and 10 after Ross procedure. [15] Patterns of associations between patient factors and opioid prescribing also vary considerably across procedure type. [16] BACKGROUND Failure of the pulmonary autograft (PVA) following the Ross procedure (RP) has discouraged its widespread use and led to modifications or alternatives to the procedure. [17] After controlling for sex, diagnosis, and functional status, there were significant differences in utilization estimates across procedure groups. [18] The likelihood of obtaining a refill was unchanged with the size of the initial perioperative prescription across procedure categories. [19] BACKGROUND The Ross procedure is rarely considered in older patients. [20] 9%) combined valve and aortic surgery and 3 had a Ross procedure. [21] Recent publications suggest a benefit of the Ross procedure over conventional AVR and highlight the need for high-quality randomised controlled trial (RCTs) on the optimal AVR. [22] Objective: The Ross procedure is thought to have the best long-term results among aortic valve surgical interventions and has excellent hemodynamic characteristics and very low risk of valve thrombosis. [23] Due to extensive AV calcifications, AV repair was not feasible, and Ross procedure was indicated. [24] The Ross procedure has been prominent for these patients, however long-term reports have revealed concerns, namely neo-aortic root dilation and regurgitation. [25] These include valve-sparing root replacement procedures if the native aortic valve can be salvaged, and the Ross procedure, which nearly eliminates prosthetic valve-related thromboembolism, anticoagulation-related hemorrhage and endocarditis. [26] In particular, in young low risk patients, there remains uncertainty regarding the optimal treatment, with unique concerns around valve durability, valve prosthesis selection, and consideration for special procedures such as the Ross procedure. [27] Background: The purpose of this study was to assess autograft function after the Ross procedure and to review surgical outcomes associated with autograft reoperations. [28] Contraindications for Ross procedure, which is performed since 1991 at the center were reviewed in the observed non-Ross AVR cohort. [29] The Ross procedure is the best operation to treat aortic stenosis (AS) in young and middle-aged adults. [30] CONCLUSION Self-reported post-surgery outpatient opioid analgesic use varies widely both across procedures and within a given procedure type. [31] CONCLUSIONS The baseline severity of scaphocephaly was similar across procedures and sites. [32] Many aspects of the techniques described in this chapter share and build off of one another and several of the endoscopic instruments utilized are also shared across procedures. [33] While previous spine surgery studies have compared charges across procedures and in the presence of comorbidities, the association between charges and hospital size in Anterior Cervical Discectomy and Fusion (ACDF) has yet to be understood. [34] The PEARS procedure offers a novel alternative to traditional surgical options for aortic root aneurysms in patients with connective tissue disorders and neo-aortic root dilatation following the arterial switch or Ross procedures. [35] Background Potential for difficult reoperations has been a concern for patients undergoing a Ross procedure. [36] Conformity across procedure type was analyzed using analysis of variance and post hoc Bonferroni analysis, where appropriate. [37] While the financial impact of these differences vary across procedures, these findings suggest that standardization may offer an opportunity for cost savings. [38] Specifically, HCR female offspring were backcrossed with male LCR (or the reciprocal) via inbreeding, and this backcross procedure was repeated over several generations to generate the LCR-mt and HCR-mt. [39] In this paper, we report on the surgical techniques of the Ross procedure and present long-term post-operative outcomes using the reinforced full-root technique. [40] The Ross procedure consists in replacing the diseased aortic valve with the patient’s own pulmonary valve and simultaneous replacement of the pulmonary valve (and root) with a pulmonary homograft (or in some cases a xenograft). [41] The Ross procedure offers several potential advantages that may translate to improved long-term outcomes. [42] The prevalence of risk factors for cardiovascular disease is similar between ACHD and the general population, but an increased risk of coronary atherosclerosis has been observed for congenital coronary artery anomalies, dextro-transposition of the great arteries after arterial switch operation, Ross procedure, and coarctation of the aorta. [43] 98 across procedures, indicating the likelihood that attending surgeons granted future autonomy complied with their evaluation of prospective resident entrustment was high. [44] Opioid consumption ranged between four and 37 pills across procedure categories. [45] The underlying anatomy comprised surgically implanted bioprosthetic valves for pulmonary regurgitation (n= 5), conduit repair for pulmonary atresia (n = 4), Rastelli repair (n = 3), truncus (n = 1), and Ross procedure (n = 2). [46] BACKGROUND The risk of the Ross procedure continues to be debated. [47] Practical implications The implications of this review highlight the need for policy and guidance to minimise variation across procedures and implementation of co-production to ensure positive outcomes and benefits for participants, given the current landscape. [48] Multidisciplinary team decision to restore best quality of life was for re-do Ross procedure with bi-leaflet preserving mitral valve replacement with an inverted RESILIA aortic valve as the patient was fundamentally against lifelong anti-coagulation. [49] Using mixture cure models, we show that time-to-failure determinants and differences across procedure types are consistent with the legislator's intentions. [50]根据现代研究人员的研究结果，儿童先天性主动脉瓣病变的主要技术包括主动脉瓣球囊导管扩张术、瓣膜成形术、Ross 手术和用机械假体置换主动脉瓣。 [1] 这些文章涉及 (1) 使用国家儿科心脏病学质量改进合作开发风险评分来预测左心发育不全综合征患者的不良结果，(2) 罗斯手术对既往主动脉瓣手术患者的结果显示出更好的结果这些患者与接受初次 Ross 手术的患者相比，(3) 在儿科患者中使用连续流动心室辅助装置的初步经验显示植入后死亡率较低，(4) 较低的社会经济地位与较差的长期神经发育结局相关左心发育不全综合征，(5) 在修复的法洛四联症中，植入式心脏复律除颤器植入后，QRS 碎裂与适当休克的发生率较高有关，(6) 如果在 Fontan 手术前进行房室瓣修复，与 Fontan 手术后相比，其结果可能更好手术。 [2] 我们还测试了测量的铅浓度在整个程序和发现的血量中的变异性，发现测量的不确定性没有显着增加。 [3] 跨程序体积三分位数评估方法性能：小 (171)。 [4] 在这种情况下，年轻患者可能会从 Ross 手术中受益，前提是它可以安全地进行并且具有足够的耐用性。 [5] 我们发现跨程序引发的风险偏好不一致。 [6] 我们试图确定这一年轻人群中 AVR 与 Ross 手术或机械 AVR 后 HRQOL 的差异。 [7] 需要多中心数据支持在长期术后瓣膜相关死亡率和再干预方面使用 Ross 程序，以及自体移植物和肺同种移植物的功能。 [8] 客观的 在接受 Ross 手术的二叶主动脉瓣成人中比较包裹（自体肺移植物包涵体）与未包裹技术的结果。 [9] 在受青睐的 Ross 手术后自体移植失败被视为 患者 作为 Ozaki 手术的候选者。 [10] 尽管影响的大小各不相同，但这些趋势在不同的程序亚组中是相似的。 [11] 客观的 尽管技术进步不可否认，但在面对罗斯手术时，难以修复需要使用瓣膜替代物的主动脉瓣病变仍然存在争议。 [12] 总体而言，RFID 跟踪代表了一种可扩展的、系统的和有效的跨程序优化仪器供应的方法。 [13] 背景：我们试图评估在儿科患者中放置右心室至肺动脉 (RV-PA) 导管后的结果，不包括那些在 Ross 手术中使用 RV-PA 导管的患者，这与改善导管耐久性有关，部分与其原位有关位置。 [14] 这项研究包括 20 名儿童，其中 10 名在 Ozaki 之后，10 名在罗斯手术之后。 [15] 患者因素与阿片类药物处方之间的关联模式也因手术类型而异。 [16] 背景 罗斯程序 (RP) 后自体肺移植物 (PVA) 的失败阻碍了其广泛使用，并导致对该程序进行修改或替代。 [17] 在控制性别、诊断和功能状态后，不同手术组的利用率估计存在显着差异。 [18] 获得补充药物的可能性随着手术类别的初始围手术期处方的大小而变化。 [19] 背景 在老年患者中很少考虑罗斯手术。 [20] 9%）联合瓣膜和主动脉手术，3 人进行了罗斯手术。 [21] 最近的出版物表明，Ross 手术优于传统 AVR，并强调需要对最佳 AVR 进行高质量随机对照试验 (RCT)。 [22] 目的：Ross 手术被认为在主动脉瓣手术干预中具有最佳的长期效果，并且具有出色的血流动力学特征和极低的瓣膜血栓形成风险。 [23] 由于广泛的 AV 钙化，AV 修复是不可行的，并指示 Ross 程序。 [24] 对于这些患者，Ross 手术非常重要，但长期报告显示了一些担忧，即新主动脉根部扩张和反流。 [25] 这些包括保留瓣膜根部置换手术（如果可以挽救原生主动脉瓣），以及几乎消除人工瓣膜相关血栓栓塞、抗凝相关出血和心内膜炎的罗斯手术。 [26] 特别是在年轻的低风险患者中，最佳治疗仍然存在不确定性，特别关注瓣膜耐用性、瓣膜假体选择以及考虑特殊手术（如罗斯手术）。 [27] 背景：本研究的目的是评估 Ross 手术后自体移植物的功能，并回顾与自体移植物再手术相关的手术结果。 [28] 在观察到的非 Ross AVR 队列中回顾了自 1991 年以来在中心进行的 Ross 手术的禁忌症。 [29] Ross 手术是治疗青壮年主动脉瓣狭窄 (AS) 的最佳手术。 [30] 结论 自我报告的手术后门诊阿片类镇痛药的使用在不同手术和给定手术类型中差异很大。 [31] 结论 舟状头畸形的基线严重程度在手术和部位之间是相似的。 [32] 本章中描述的技术的许多方面相互共享和相互借鉴，并且所使用的几种内窥镜器械也在整个程序中共享。 [33] 虽然之前的脊柱手术研究比较了不同程序和存在合并症的费用，但在颈椎前路椎间盘切除融合术 (ACDF) 中，费用与医院规模之间的关联仍有待了解。 [34] PEARS 手术为患有结缔组织疾病和动脉开关或 Ross 手术后新主动脉根部扩张的患者的主动脉根部动脉瘤提供了一种新的替代手术选择。 [35] 背景 对于接受罗斯手术的患者来说，再手术困难的可能性一直是一个问题。 [36] 在适当的情况下，使用方差分析和事后 Bonferroni 分析分析跨程序类型的一致性。 [37] 虽然这些差异对财务的影响因程序而异，但这些发现表明标准化可能提供节省成本的机会。 [38] 具体来说，HCR 雌性后代通过近亲繁殖与雄性 LCR（或倒数）回交，并且这种回交过程重复了几代以产生 LCR-mt 和 HCR-mt。 [39] 在本文中，我们报告了 Ross 手术的手术技术，并介绍了使用强化全根技术的长期术后结果。 [40] 罗斯手术包括用患者自己的肺动脉瓣替换患病的主动脉瓣，同时用肺同种移植物（或在某些情况下异种移植物）替换肺动脉瓣（和根部）。 [41] 罗斯程序提供了几个潜在的优势，可以转化为改善的长期结果。 [42] 心血管疾病危险因素的患病率在 ACHD 和普通人群中相似，但已观察到先天性冠状动脉异常、动脉开关手术后大动脉右转转位、Ross 手术和缩窄导致冠状动脉粥样硬化的风险增加的主动脉。 [43] 98 跨程序，表明主治外科医生授予未来自主权符合他们对未来居民委托的评估的可能性很高。 [44] 整个程序类别的阿片类药物消耗量在 4 到 37 粒之间。 [45] 基础解剖结构包括手术植入的用于肺反流的生物瓣膜（n = 5）、用于肺闭锁的导管修复（n = 4）、Rastelli 修复（n = 3）、躯干（n = 1）和 Ross 手术（n = 2） ）。 [46] 背景 罗斯程序的风险仍在争论中。 [47] 实际影响 本次审查的影响强调了政策和指导的必要性，以最大限度地减少程序之间的差异和联合制作的实施，以确保在当前形势下为参与者带来积极的成果和利益。 [48] 恢复最佳生活质量的多学科团队决定重新进行 Ross 手术，使用倒置 RESILIA 主动脉瓣置换保留双叶的二尖瓣，因为患者从根本上反对终生抗凝治疗。 [49] 使用混合治疗模型，我们表明失败时间的决定因素和程序类型之间的差异与立法者的意图是一致的。 [50]
aortic valve replacement
Some subjects in this scenario arise, including the importance of optimized prosthetic hemodynamics for lifetime care; surgical procedures in the aortic root; management of structural valve degeneration with valve-in-valve procedures (TAVR-in-surgical aortic valve replacement [SAVR] and TAVR-in-TAVR) and redo SAVR; commissural alignment and cusp overlap for TAVR; the rise in the number of surgical procedures for TAVR explantation; and the renewed interest in the Ross procedure. [1] OBJECTIVE The Ross procedure is an excellent option for children or young adults who need aortic valve replacement because it can restore survival to that of the normal aged-matched population. [2] Though some patients may require variations in the approach to management, the ultimate goal should be to perform a Ross procedure when aortic valve replacement is indicated. [3] Surgical management of UAV stenosis includes aortic valve replacement through standard open heart surgery or percutaneous transcatheter aortic valve replacement (TAVR), aortic valve repair either by bicuspidization, tricuspidization or trileaflet reconstruction, or the Ross procedure. [4] The current gold-standard aortic valve replacement surgery is called the Ross procedure—where replacement is undertaken with a competent pulmonic valve and a simultaneous pulmonary homograft. [5] Re-interventions after pulmonary autograft aortic valve replacement (Ross procedure) may be associated with dysfunction of the neoaortic, neopulmonary, or both operated valves. [6] The Ross procedure remains the best aortic valve replacement option for children and young adults due to the superior hemodynamics, resistance to infection, durability and lack of thrombogenicity when compared to bioprostheses and mechanical valve options. [7] The Ross procedure, unlike prosthetic or homograft aortic valve replacement (AVR), provides an expected survival equivalent to that of the age and gender-matched general population. [8] , Ross procedure) for aortic valve replacement is associated with excellent long-term results in non-elderly patients. [9] Objective: The Ross procedure has been cited as the procedure of choice for young patients requiring aortic valve replacement. [10]在这种情况下会出现一些主题，包括优化假肢血流动力学对终生护理的重要性；主动脉根部的外科手术；通过瓣中瓣手术（TAVR-in-surgical主动脉瓣置换术 [SAVR] 和 TAVR-in-TAVR）和重做 SAVR 管理结构性瓣膜退变； TAVR 的连合对齐和牙尖重叠； TAVR 移植手术数量的增加；以及对罗斯程序的新兴趣。 [1] 客观的 对于需要主动脉瓣置换术的儿童或年轻人来说，Ross 手术是一个很好的选择，因为它可以将生存率恢复到正常年龄匹配人群的生存率。 [2] nan [3] nan [4] nan [5] nan [6] nan [7] nan [8] nan [9] nan [10]
aortic valve disease
The surgical options for significant aortic valve disease include either Ross procedure (RP) or aortic valve replacement (AVR). [1] : Ross procedure is a valid option for the treatment of aortic valve disease in children and young adults. [2] The aim of the study was to evaluate the medium-term results of aortic valve neocuspidalization according to Ozaki compared to Ross procedure for treatment of isolated aortic valve disease in pediatric age. [3] OBJECTIVES The Ross procedure is an attractive option for the management of aortic valve disease in paediatric patients. [4] The excellent clinical outcomes of the Ross procedure and previous histological studies suggest that the pulmonary autograft has the potential to offer young patients a permanent solution to aortic valve disease. [5] Objective The Ross procedure is an established option for aortic valve disease in children. [6]严重主动脉瓣疾病的手术选择包括罗斯手术 (RP) 或主动脉瓣置换术 (AVR)。 [1] ：Ross 手术是治疗儿童和年轻人主动脉瓣疾病的有效选择。 [2] nan [3] nan [4] nan [5] nan [6]
right ventricular outflow
Pulmonary autograft replacement of the aortic valve, commonly known as the Ross procedure, involves excision of the pulmonary valve from the right ventricular outflow tract and implantation in the aortic position. [1] Background The Ross procedure involves autograft transplantation of the native pulmonary valve into the aortic position and reconstruction of the right ventricular outflow tract (RVOT) with a homograft. [2] , Kennesaw, GA, USA) and non-decellularized cryopreserved pulmonary homografts, which were used for right ventricular outflow tract reconstruction in the Ross procedure. [3] The majority of the cases were reported after transcatheter interventions on the PAs or right ventricular outflow tract (RVOT), in patients with transposition of great arteries (TGA) who underwent PA angioplasty following arterial switch operation (ASO) or after transcutaneous pulmonary valve replacement in patients who had undergone a Ross procedure. [4]主动脉瓣的自体肺移植物置换术，通常称为罗斯手术，包括从右心室流出道切除肺动脉瓣并植入主动脉位置。 [1] 背景 Ross 手术包括将天然肺动脉瓣自体移植到主动脉位置，并用同种移植物重建右心室流出道 (RVOT)。 [2] nan [3] nan [4]
year old male
A 63 year old male with congenital bicuspid aortic valve status post Ross procedure complicated by multiple sternotomies to treat a failed pulmonic homograft and pseudoaneurysm repair of both ventricular outflow tracts, bioprosthetic aortic valve replacement with subsequent endocarditis who presented with recurrent pulmonic/aortic vavlulopathy successfully treated with transcatheter intervention. [1] We report the case of an 18-year-old male with a history of bicuspid aortic valve with severe aortic insufficiency who had undergone a Ross procedure one year prior, but subsequently developed stenosis of the pulmonary homograft necessitating conduit replacement. [2] This thirty-nine-year-old male underwent a Ross procedure ten years ago as the primary cardiac operation. [3]一名 63 岁男性先天性二叶主动脉瓣状态柱 罗斯手术通过多次胸骨切开术来治疗失败 双侧心室流出道的肺同种异体移植和假性动脉瘤修复 大束，生物人工主动脉瓣置换术，随后 出现复发性肺/主动脉瓣膜病的心内膜炎 经导管介入治疗成功。 [1] 我们报告了一名 18 岁男性的病例，他有严重主动脉瓣关闭不全的二叶主动脉瓣病史，他在一年前接受了 Ross 手术，但随后出现了需要更换导管的肺同种移植物狭窄。 [2] nan [3]
excellent long term
Although several high-volume international centers and surgeons have demonstrated excellent long-term results with the pulmonary autograft (Ross procedure) in adult patients, current guidelines from the United States do not favor this technique. [1] Background The neo-aorta produced by the pulmonary autograft following the Ross procedure has excellent long-term outcomes, with an increasing number of women now undergoing pregnancy following Ross. [2]尽管一些高容量的国际中心和外科医生在成人患者中使用自体肺移植（Ross 手术）取得了良好的长期效果，但美国目前的指南并不支持这种技术。 [1] nan [2]
aortic valve repair
To compare long-term outcomes of aortic valve repair (AVr) and pulmonary autograft replacement (Ross procedure) in terms of echocardiographic parameters, quality of life (QoL), physical activity (PA). [1] Neo-aortic valve repair and the Ross procedure are good surgical options in such patients. [2]比较主动脉瓣修复术 (AVr) 和自体肺移植物置换术 (Ross 手术) 在超声心动图参数、生活质量 (QoL)、体力活动 (PA) 方面的长期结果。 [1] 新主动脉瓣修复术和罗斯手术是此类患者的良好手术选择。 [2]
ross procedure type
Patterns of associations between patient factors and opioid prescribing also vary considerably across procedure type. [1] Conformity across procedure type was analyzed using analysis of variance and post hoc Bonferroni analysis, where appropriate. [2] Using mixture cure models, we show that time-to-failure determinants and differences across procedure types are consistent with the legislator's intentions. [3] CONCLUSIONS Procedural difficulty significantly differed across procedure type. [4] However, differences in outcomes across procedure types may vary between unilateral versus bilateral reconstructions. [5]患者因素与阿片类药物处方之间的关联模式也因手术类型而异。 [1] 在适当的情况下，使用方差分析和事后 Bonferroni 分析分析跨程序类型的一致性。 [2] 使用混合治疗模型，我们表明失败时间的决定因素和程序类型之间的差异与立法者的意图是一致的。 [3] nan [4] nan [5]
ross procedure category
The likelihood of obtaining a refill was unchanged with the size of the initial perioperative prescription across procedure categories. [1] Opioid consumption ranged between four and 37 pills across procedure categories. [2]获得补充药物的可能性随着手术类别的初始围手术期处方的大小而变化。 [1] 整个程序类别的阿片类药物消耗量在 4 到 37 粒之间。 [2]