PDF(Pubmed)
Abstract：
The surgical treatment options for pediatric aortic valve disease are limited and have debatable long-term durability. In the current situation, the Ross procedure is considered in children for aortic valve disease(s). It is a complex surgical procedure with the risk of neo-aortic dilatation, converting a single valve disease into double valve disease, and associated with future re-interventions. Conversely, the Ozaki procedure has shown promising results in adults. Thus, the present study aimed to provide comparative evidence on the effectiveness and safety of the Ozaki versus Ross procedure for pediatric patients by performing a meta-analytic comparison of reporting outcomes. A total of 15 relevant articles were downloaded and among them, seven articles (one prospective study, five retrospective studies, and one case series) were used in the analysis. Primary outcomes such as physiological laminar flow pattern and hemodynamic parameters, and secondary outcomes such as hospital stays, adverse effects, mortality, and numbers of re-intervention(s) were measured in the meta-analysis. There were no significant differences in the age of patients between children who underwent the Ozaki procedure and those who underwent the Ross procedure at the time of surgeries. The Ozaki procedure is a good solution to an aortic problem(s) similar to the Ross procedure. Unlike the Ross procedure, the Ozaki procedure has restored a physiological laminar flow pattern in the short-term follow-up without the bi-valvular disease. Mean hospital stays (p = 0.048), mean follow-up (p = 0.02), adverse effects (p = 0.02), death, and numbers of re-intervention(s) of children who underwent the Ozaki procedure were fewer than those who underwent the Ross procedure. The time required for re-intervention(s) is higher for children who underwent the Ozaki procedure than those who underwent the Ross procedure. None of the procedures, including the Ozaki procedure for aortic valve disease(s), has significant effects on hemodynamic parameters and the frequent death rate of children after surgeries. Based on our analysis, we may suggest the Ozaki procedure for aortic valve disease surgery in children.
摘要：
小儿主动脉瓣疾病的手术治疗选择有限，并且具有有争议的长期耐久性。在当前形势下,在主动脉瓣疾病的儿童中考虑Ross手术。这是一个复杂的外科手术，有新主动脉扩张的风险，将单瓣膜疾病转化为双瓣膜疾病，并与未来的重新干预有关。相反，Ozaki程序在成人中显示出有希望的结果。因此，本研究旨在通过对报告结局进行荟萃分析比较,为Ozaki和Ross手术对儿科患者的有效性和安全性提供比较证据.共下载15篇相关文章,其中,七篇文章(一项前瞻性研究，五项回顾性研究,和一个案例系列)用于分析。主要结果，如生理层流模式和血液动力学参数，和次要结果，如住院时间，不利影响，死亡率,在荟萃分析中测量了再干预的数量。接受Ozaki手术的儿童和在手术时接受Ross手术的儿童之间的患者年龄没有显着差异。Ozaki程序是类似于Ross程序的主动脉问题的良好解决方案。与罗斯程序不同,Ozaki手术在没有双瓣膜疾病的短期随访中恢复了生理层流模式。平均住院时间（p=0.048），平均随访(p=0.02)，不良反应（p=0.02），死亡,接受Ozaki手术的儿童的再干预数量少于接受Ross手术的儿童。接受Ozaki手术的儿童比接受Ross手术的儿童需要的时间更长。没有任何程序，包括主动脉瓣疾病的Ozaki手术，对患儿术后血流动力学参数和频繁死亡率有显著影响。根据我们的分析,我们可能建议Ozaki手术用于儿童主动脉瓣疾病手术。
