总体上,患者在肺动脉瓣置换术后恢复良好。[5]Schmidtke C, Bechtel JF, Noetzold A, et al. Up to seven years of experience with the Ross procedure in patients >60 years of age. J Am Coll Cardiol. 2000 Oct;36(4):1173-7.http://www.ncbi.nlm.nih.gov/pubmed/11028467?tool=bestpractice.com[12]Therrien J, Siu SC, McLaughlin PR, et al. Pulmonary valve replacement in adults late after repair of tetralogy of Fallot: are we operating too late? J Am Coll Cardiol. 2000 Nov 1;36(5):1670-5.https://www.sciencedirect.com/science/article/pii/S073510970000930X?via%3Dihubhttp://www.ncbi.nlm.nih.gov/pubmed/11079675?tool=bestpractice.com[13]Discigil B, Dearani JA, Puga FJ, et al. Late pulmonary valve replacement after repair of tetralogy of Fallot. J Thorac Cardiovasc Surg. 2001 Feb;121(2):344-51.https://www.jtcvs.org/article/S0022-5223(01)38812-8/fulltexthttp://www.ncbi.nlm.nih.gov/pubmed/11174741?tool=bestpractice.com 独立肺动脉瓣置换的早期病死率在儿童中为1%,10年免于生物瓣膜衰败再次手术率为90%。[23]Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. 2008;118:e714-e833.http://circ.ahajournals.org/cgi/content/full/118/23/e714http://www.ncbi.nlm.nih.gov/pubmed/18997169?tool=bestpractice.com 使用机械瓣膜的患者应当监测华法林的出血性并发症。
对于那些重度肺动脉瓣反流、有手术适应证却未手术的患者,其预后取决于一系列因素,包括造成肺动脉瓣反流的原发性疾病、是否累及其他瓣膜、是否伴发冠状动脉病变以及是否存在右心室扩张或功能不全。已经证实在法洛四联症矫治术后伴慢性肺动脉瓣反流的患者中,其右心室扩张与猝死率的增高有关。
尚无针对特发性肺动脉瓣反流患者使用人工瓣膜的大型临床试验能够为未治疗患者预后提供证据。