谁会受益
The Ross procedure is for younger patients with aortic valve disease but no other major medical problems, 比如肝脏, 肾脏或肺部疾病. We generally perform the procedure only in those around age 60 and under.
其他可能从手术中受益的人包括:
- 计划要孩子的妇女
- Patients who are experiencing a failed valve from a previous aortic valve replacement
- Those with a very small aortic valve in need of replacement (often women and children)
The treatment isn't an option for patients over 70 or people with Marfan syndrome; pulmonary valve disease; autoimmune disorders, such as lupus; or significant kidney, liver, lung, 冠状动脉或二尖瓣疾病.
Advantages
The Ross procedure's advantages over standard valve replacements include:
- 瓣膜的寿命比动物组织瓣膜长.
- 和组织瓣膜相比, the relocated valve has a lower risk of postoperative deterioration from calcification (tissue hardening caused by calcium deposits).
- 不需要服用血液稀释剂(不像机械阀).
- 降低瓣膜感染、出血或中风的风险.
- 减少身体排斥瓣膜的机会.
- 更容易调节血液流动.
- 使60岁以下病人的预期寿命恢复正常.
Evaluation
来决定你是否适合做罗斯手术, your doctor will assess the condition of your aortic valve and your overall cardiovascular health, 通常借助于以下一种或多种测试:
- Echocardiogram. 也叫心脏超声, this noninvasive test uses sound waves to produce detailed images of your heart, allowing doctors to assess the structure of its chambers and valves and observe blood flow. 经胸超声心动图, the images are captured by placing a transducer (the device emitting sound waves) in various spots on the chest and abdomen. 经食管超声心动图, 一根细管将换能器送入食道, 使十大赌博平台排行榜能够获得人体内部的图像.
- 冠状动脉CT血管造影. This noninvasive test uses X-rays to create images of the blood vessels in the chest, 包括主动脉和肺动脉.
- 冠状动脉造影. 导管(细的), flexible tube) is threaded through a blood vessel in your wrist or groin to an artery in your heart, and a harmless dye that shows up well on X-rays is injected into the catheter. The test provides detailed images that reveal how well the coronary arteries are functioning and also allows doctors to measure the pressure inside the heart chambers.
Procedure
The Ross procedure is open-heart surgery, requiring general anesthesia (you're completely asleep). 外科十大赌博平台排行榜切开胸骨进入你的心脏. 因为你的心脏必须暂时停止跳动, 你被安置在心肺搭桥机上, 是什么让血液在你体内循环. 外科十大赌博平台排行榜检查并切除病变的主动脉瓣, then examines 肺动脉瓣 to check that it's a healthy and suitable replacement. If it is, the valve is removed and implanted in place of the aortic valve. 然后外科十大赌博平台排行榜植入一个供体肺动脉瓣. 手术通常需要4到5个小时.
Recovery
预计在十大赌博平台排行榜待5到7天, 前两三个在重症监护室. We encourage you to be up and walking within 24 hours of the surgery; most patients are able to do so. 在你术后住院期间, follow-up tests are performed to determine that your heart valves are functioning properly. These may include chest X-rays, blood tests, an electrocardiogram (EKG) and an echocardiogram.
回家之前, your heart care team will talk with you about how to care for yourself, 提供饮食指导, exercise, 小心你的切口, 以及使用现有或新的药物.
We recommend six weeks of restricted activity while you recover from the surgery. For part of that time, we may also prescribe certain medications, including:
- 利尿剂(增加排尿的药物),所以你不会保留水分
- 止痛药,剂量逐渐减少
- Beta-blockers to help keep your blood pressure low while your pulmonary valve "learns" how to be an aortic valve
- ACE(血管紧张素转换酶)抑制剂, for additional blood pressure control or if you had severe valve regurgitation with a dilated left ventricle
Risks
虽然罗斯手术的结果经得起时间的考验, there is about a 1% per year chance of needing another procedure to fix issues with the aortic or pulmonary valve. (That's better than treatment with tissue valves but more frequent than with mechanical valves.大约有一半的时间, 我们不用开胸手术就能解决这个问题, 有一半的时间, 病人需要再做一次心脏直视手术. However, of the four main complications that can occur after aortic valve surgery – namely, 再手术(再手术), bleeding, 感染和卒中再手术的风险最低.