天津医药

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经胸骨上段小切口主动脉瓣置换术

贾立群1,梁德刚1,阮昕华2,付强1,李全正3,魏民新1   

  1. 1. 天津医科大学总医院
    2.
    3. 天津医科大学总医院心血管外科
  • 收稿日期:2012-01-06 修回日期:2012-03-20 出版日期:2012-11-15 发布日期:2012-11-15
  • 通讯作者: 魏民新

Superior minor median sternotomy aortic valve replacement in 35 patients

  • Received:2012-01-06 Revised:2012-03-20 Published:2012-11-15 Online:2012-11-15
  • Contact: Minxin Wei

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摘要： 【摘要】目的 回顾本中心胸骨上段小切口主动脉瓣置换术的经验。方法 2009年3月至2011年11月,经胸骨上段小切口主动脉瓣置换术35例。13例早期手术患者经升主动脉、右房建立体外循环，22例患者经股动、静脉建立体外循环。除10例患者外，均使用负压引流系统（VAVD），共7例患者经肺动脉建立左心引流。 结果1例术后30天因突发脑梗塞死亡，2例术后浅层伤口愈合不良。体外循环时间92.3±15.6分钟,主动脉阻断时间48.6±19.2 分钟。术后气管插管时间8.6±1.5小时，术后住院时间9.5±3.6天。术后随访3-32月，心功能良好。结论 胸骨上段小切口主动脉瓣置换术能够保持胸廓连续性，与传统胸正中切口比较，具有创伤小、恢复快等优点, 可以在部分心脏手术患者群推广。 【关键词】 胸骨上段小切口;心脏手术;心脏外科

关键词: 胸骨上段小切口, 心脏手术, 心脏外科

Abstract: 【Abstract】Objective To summarize the experience of superior minor median sternotomy aortic valve replacement surgery. Methods From 2009.3 to 2011.11, 35 patients underwent superior minor median sternotomy aortic valve replacement operation were collected retrospectively. 13 patients were performed with the extracorporeal circulation through ascending aorta and right atrium, other 22 patients with extracorporeal circulation through femoral artery and femoral vein。Except for 10 patients, all the others got vacuum-assisted venous drainage(VAVD). 7 cases got drainage through pulmonary artery. Results 1 patients died of cerebral infarction on the 30th day after surgery. Delayed wound healing appeared in 2 patients. Cardiopulmonary bypass time was 92.3±15.6 min, aortic cross clamping time was 48.6±19.2 min, duration of postoperative mechanical ventilation was 8.6±1.5 hours, and postoperative hospital stay was 9.5±3.6 days (range, 8 days-16 days). Conclusions Superior minor median sternotomy aortic valve replacement surgery could keep integrity of the sternum. Compared with the traditional midsternalthoractomy, the surgery could offer quick recovery and excellent cosmetic effect to some patients. 【Key words】Superior minor median sternotomy; open heart surgery；Cardiac Surgery

Key words: Superior minor median sternotomy, open heart surgery, Cardiac Surgery