天津医药

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经肋间小切口心脏直视手术28例应用体会

魏民新1,贾立群1,梁德刚1,阮昕华2,李全正3,付强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:2011-12-20 修回日期:2012-03-20 出版日期:2012-07-15 发布日期:2012-07-15
  • 通讯作者: 魏民新

Trans-intercostal mini-thoracotomy cardiac surgery

  • Received:2011-12-20 Revised:2012-03-20 Published:2012-07-15 Online:2012-07-15
  • Contact: Minxin Wei

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摘要： 目的 回顾分析经肋间小切口心脏直视手术的经验。方法 2010年5月至2011年8月,经右侧肋间小切口施行心脏直视手术28例，其中二尖瓣置换13例，二尖瓣置换加三尖瓣成形2例，二尖瓣置换加冠脉搭桥1例，房间隔缺损3例，房间隔缺损修补加三尖瓣成形3例，左房粘液瘤4例，主动脉瓣置换2例。结果 患者全部治愈出院。术后皮下气肿2例，二次开胸止血一例。体外循环时间55.6±14.3分钟,主动脉阻断时间31.4±12.5 分钟。术后气管插管时间7.2±1.8小时，术后住院时间8.2±2.4天。术后随访3-14月，心功能良好。结论 肋间小切口心脏直视手术保持胸廓连续性，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: 小切口, 心脏直视手术, 心脏外科

Abstract: Objective To summarize the experience of intercostal mini-thoracotomy cardiac surgery. Methods From 2010.5 to 2011.8, 28 patients underwent right trans-intercostal mini-thoracotomy cardiac operation were collected retrospectively. The surgery included 13 cases of mitral valve replacement, 2 cases of mitral valve repairment, 2 cases of mitral valve replacement with tricuspid valve repairment, 1 case of mitral valve replacement and CABG, 3 cases of ASD repairment, 3 cases of ASD repairment with tricuspid valve repairment, 4 cases of left atrial myxoma resection, 2 cases of aortic valve replacement. Results All the patients were survived. Subcutaneous emphysema occurred in 2 patients. One patient got re-thoractomy. Cardiopulmonary bypass time was 55.6±14.3 min, aortic cross clamping time was 31.4±12.5 min, duration of postoperative mechanical ventilation was 7.2±1.8 hours, and postoperative hospital stay was 8.2±2.4 days (range, 5 days-12 days). Conclusions Trans-intercostal mini-thoracotomy cardiac surgery could keep integrity of the sternum. Compared with the traditional midsternalthoractomy, the mini-thoracotomy cardiac surgery could offer quick recovery and excellent cosmetic effect to some patients.

Key words: Minimally invasive, Open heart surgery, Cardiac Surgery