表现为单纯主动脉瓣关闭不全的主动脉夹层的外科治疗

目的探讨表现为单纯主动脉瓣关闭不全的主动脉夹层的临床特点及外科治疗方法,避免术前误诊,为临床诊治提供参考。方法回顾性分析2005年1月至2012年5月北京阜外心血管病医院5例术前诊断为主动脉瓣关闭不全的主动脉夹层患者的临床资料,其中男4例,女1例;中位年龄4l（34～53）岁。5例均在术中诊断为主动脉夹层,1例行单纯主动脉瓣成形术,1例行Wheat手术,3例行Bentall手术。对其临床表现、辅助检查、术中所见、手术方式及随访结果进行分析总结。结果本组患者均无手术死亡及无手术相关并发症,例1出院前超声心动图提示升主动脉及窦部横径均较术前减小,主动脉瓣对合良好,无明显反流;余4例患者复查超声心动图及CT均提示机械瓣启闭良好,人工血管通畅。5例患者得到随访,中位随访时间4（1～5）年,均生存。4例患者复查超声心动图均提示机械瓣启闭良好,无明确瓣周漏,人工血管通畅;1例主动脉瓣有少量反流。结论表现为单纯主动脉瓣关闭不全的主动脉夹层少见,术前易误诊,仔细分析病史结合辅助检查可在一定程度上避免误诊,手术中宜根据主动脉内膜撕裂及窦部破坏程度决定手术方式。     

主动脉瓣成形术治疗主动脉瓣关闭不全46例

主动脉瓣成形术治疗主动脉瓣关闭不全４６例梁家立张广福姜冠华王振祥我院自１９８０年１月～１９９５年１２月应用主动脉瓣成形术治疗先天性心脏病中的主动脉瓣关闭不全４６例，取得了满意治疗效果。现就主动脉瓣关闭不全的原因、手术方法等问题进行分析讨论。１临床资料...     

主动脉瓣成形术治疗主动脉瓣关闭不全进展

主动脉瓣成形术治疗主动脉瓣关闭不全是利用外科技术在保留患者自身瓣膜结构基础上对病变的主动脉瓣结构进行修复、成形,以达到恢复其生理功能的目的。根据主动脉瓣不同的病变性质和程度,成形范围包括瓣叶和瓣环。与主动脉瓣置换术相比,主动脉瓣成形术保留了自体瓣膜的完整、左室功能恢复较好、手术死亡率低,无须终生抗凝,适用于任何年龄的患者。本文就主动脉瓣成形术治疗主动脉瓣关闭不全的临床进展情况进行综述。     

主动脉瓣关闭不全合并左心室功能不全的外科治疗

目的总结主动脉瓣关闭不全合并左心室功能不全的外科治疗经验,评价其治疗措施、疗效和预后。方法回顾性分析第二军医大学附属长海医院2000年1月至2009年12月治疗的68例主动脉瓣关闭不全合并左心室功能不全（左心室射血分数≤40％）患者的临床资料,其中男54例,女14例;年龄12～75岁（50．30±13．90岁）。所有患者均行主动脉瓣置换术,同期行冠状动脉旁路移植术（CABG）6例,室间隔缺损修补术3例,有中度以上二尖瓣反流患者均行二尖瓣成形术（包括Reed成形、加用二尖瓣成形环等）,中度以上三尖瓣反流患者同期行三尖瓣成形术（包括Kay成形术、改良DeVega成形术）。结果围术期死亡7例,死于低心排血量综合征2例,多器官功能衰竭3例和恶性心律失常2例。术后并发低心排血量7例,肾功能不全2例,恶性心律失常l例,肺部感染和切口感染各1例;均经相应的治疗治愈。术后随访6l例,随访时间1～6个月。术后6个月左心室舒张期末内径（55．43±9．52mmVS．73．05±12．71mm,P〈O．05）、左心室舒张期末容积（156．19±70．31m1VS．293．43±109．91ml,P〈O．05）较术前明显减小;左心室射血分数（47．13％±11．60％vs．36．68％±4．92％,P（0．05）较术前明显增大。结论主动脉瓣关闭不全合并左心室功能不全患者围术期病死率较高;但采取适当的外科治疗措施,对改善患者预后、提高患者生存率具有重要的临床意义。     

主动脉瓣成形术治疗先天性主动脉瓣关闭不全12例

2001年12月至2003年8月,我们对12例先天性主动脉瓣关闭不全(A I)患者采用主动脉瓣成形术(AVP)治疗,取得了较好的手术结果。1临床资料与方法本组共12例,男8例,女4例;年龄11~28岁,平均年龄20.5岁。所有患者均为先天性A I,合并室间隔缺损(V SD)2例、双腔右心室1例、感染性心内膜炎     

升主动脉瘤合并主动脉瓣关闭不全的外科治疗

目的总结21例升主动脉瘤合并主动脉瓣关闭不全的外科治疗经验。方法19例行Bentall手术,2例行Cabrol手术;5例同时置换二尖瓣。术前心功能IV级15例,III级6例。动脉瘤直径6～11 cm,平均(8.5±2.6) cm;17例主动脉内膜有撕裂,其中5例升主动脉远端仍有夹层。主动脉瓣环直径2.7～5.4 cm,平均(3.2±1.8）cm。超声心动图检查均示主动脉瓣严重关闭不全。结果手术后无早、晚期死亡,术后超声心动图和造影检查示主动脉瓣关闭良好,移植的冠状动脉通畅、无扭曲,效果满意。结论动脉瘤直径大于6 cm时应及时随访和做预防性手术,一旦发现夹层动脉瘤应立即手术,Bentall手术治疗升主动脉瘤效果良好。     

升主动脉瘤伴主动脉瓣关闭不全外科治疗25例

报告２５例升主动脉瘤伴主动脉瓣关闭不全的手术经验。方法１１例伴有主动脉夹层分离，其中ＤｅＢａｋｅｙⅠ型６例、Ⅱ型５例。施行Ｂｅｎｔａｌ手术１９例，分别置换主动脉瓣及升主动脉１例，升主动脉置换加主动脉瓣悬吊５例。结果因止血困难采用Ｃａｂｒｏｌ分流止血２例；术后１６小时延迟大出血１例；无早期死亡病例。远期因心内膜炎死亡２例；术后３０月发生胸降主动脉瘤１例；无假性动脉瘤发生。结论应根据升主动脉瘤的病变类型及范围采用不同的手术方式。准确的吻合技术、保留瘤壁的完整性，使升主动脉瘤的手术治疗更为安全。心内膜炎是Ｂｅｎｔａｌ手术后最主要的远期并发症，须引起高度重视     

室间隔缺损合并主动脉瓣脱垂与关闭不全的外科治疗

报告１０例室间隔缺损合并主动脉瓣关闭不全与脱垂的临床特点及治疗方法。发病率占同期室间隔缺损修补术的３．２％，其中８例行主动脉瓣成形术；１例主动脉瓣替换术；１例单纯室间隔缺损修补。手术效果满意。我们对发病机制，不同类型的主动脉瓣病变采用不同的手术方法进行了分析和讨论。     

室缺并主动脉瓣关闭不全及瓦氏窦瘤破裂的治疗

室缺并主动脉瓣关闭不全及瓦氏窦瘤破裂的治疗孙全胜张孝轩王国祥张伟王伟作者单位：２２１００２徐州医学院附属医院胸心外科我们自１９９１年８月至１９９４年８月，收治了６例室间隔缺损（ＶＳＤ）合并中、重度主动脉瓣关闭不全和瓦氏窦瘤破裂的病例，采用不同的手术方...     

二尖瓣狭窄伴主动脉瓣关闭不全30例

我院于1994年8月～1999年10月共收治30例风湿性二尖瓣狭窄伴轻度主动脉瓣关闭不全患者,行单纯二尖瓣置换术5例,双瓣膜置换术25例,现报告如下。1　临床资料与方法本组30例,男12例,女18例。年龄25～57岁,平均年龄36岁。病程2～25年。心功能:级6例,级20例,级4例。心胸比率0.50～0.70,平均0.55。肺动脉压均高于7.5kPa(56mmHg),其中>10kPa(75mmHg)20例,>12kPa(90mmHg)5例。肺功能重度减退8例。心电图示心房颤动24例,窦性心律6例;伴频发性、多源性或短暂阵发性室性心动过速9例。心脏超声心动图示轻度主动脉瓣关闭不全24例,轻至中度关闭不全6例;…     

非特异性主动脉炎合并主动脉瓣病变的外科治疗

目的 总结非特异性主动脉炎合并主动脉瓣病变初次和再次手术的方法和疗效.方法 2000年1月至2011年6月手术治疗34例非特异性主动脉炎合并主动脉瓣病变患者,其中23例主动脉炎,11例白塞病.初次手术行Bentall术18例,主动脉瓣置换术(AVR) 16例.16例AVR者14例术后并发严重瓣周漏再次手术,其中根部置换术10例,人工带瓣管道8例,同种带瓣管道2例;非原位AVR术后4例.结果 初次手术行Bentall术者18例,随访4个月～11年,均长期生存,无根部假性瘤.再次手术14例均生存,出院.1例行同种带瓣管道置换术患者术后14个月因根部假性瘤破裂死亡.结论 非特异性主动脉炎合并主动脉瓣病变患者术前明确诊断困难,漏诊率极高.初次手术应采用根部置换术,再次手术十分困难,根部置换术可取得比较好的疗效,非原位AVR术操作简单、术中止血容易,术后疗效可靠,是一种可供选择的有效方法.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

目的 分析影响Ross手术后中、远期主动脉瓣反流的危险因素.方法 自1998年3月至2007年7月,47例主动脉瓣瓣膜疾病病人接受Ross手术,其中男25例,女22例;平均年龄(13.31±5.79)岁.术前诊断风湿性心脏病6例,先天性心脏病41例.病人均采用经胸超声评价主动脉瓣反流情况,采用Logistic:回归分析主动脉瓣反流危险因素.结果 全部病例随访(36.15±22.1)个月,均生存.主动脉窦径及主动脉瓣环直径均较术前明显增加,新主动脉瓣免于轻度以上反流率为82.9%.Logistic回归分析发现,术前主动脉瓣二瓣化畸形、术前主动脉瓣环扩大及病人年龄大于14岁为术后主动脉瓣反流的危险因素.结论 Ross手术治疗主动脉瓣膜疾病安全、有效,主动脉瓣可随机体发育而生长,其中、远期效果满意.年龄大于14岁、术前主动脉瓣环扩大及术前主动脉瓣二瓣化畸形是增加Ross手术后主动脉瓣反流的危险因素.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.     

Ross术后中远期主动脉瓣反流的危险因素分析

Objective To analyze the risk factors of the postoperative mid- and long-term aortic valvular regurgitation after ROSS procedure(pulmanary valve homograft transplantation). Methods Between March 1998 and July 2007,47 patients[25male, 22 female, mean age (13.31±5.79) years, ronge 1-34 years] with aortic valvular disease underwent the Ross procedure at our insti tution. There were 6 patients suffering fron rheumatic heart disease and 41 patients suffering from congenital heart disease. The aver age aortic blood flow velocity was (4.67±3.47) m/s, the average pressure gradient across aortic valve (88.26±58.06)mm Hg, LVEDD (45.53 ±10.78) mm, EF 0.69±0.08. All the patients were followed up in out-patient departement by ultrasonic cardio gram. Multiple logistic regression analysis was performed to find out the risk factors of the postive aortic valvular regurgitation. Results There was no poetoperative death in hospital. The mean follow-up periods was (36.15±22.1) months, rasnge from 12 to 110 months and none long-dated death. Compared with the data recorded in hospital, the diamenters of the aortic sinus and aortic annu lus enlarged significantly, respectively from (26.16±5.10) mm to (32.37±6.84) tam and from (19.41 ～3.98) mm to (23.45± 5.86) mm. The average flow velocity d the homograft (new aortic valve) was(1.39±0.48) m/s, graclient pressure (8.17+6.16) mm Hg. Mild aortic regurgitstion was present in 5 patients (10.6%), moderate aortic tegmgitafion in 2 pmieats (4.3%) and aevere aortic regurgitation in 1 petient (2.1%). The rate of free from regurgitation was 82.9%. Multiple logistic analyses identified the per esence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years as the risk factors for posterative aortic regurg itation. Conclusion The Ross procedure is a safe and effective procedure with good clinical results in mid-and long-term follow-up. However, the presence of bicuspid aortic valve, enlargement of aortic annulus and age above 14 years preoperatively were identified as the risk factors for postoperative aortic regurgitation.