Yu Shi Qiang, Cai Zhen Jie, Cheng Yun Ge, Duan Da Wei, Xu Xue Zheng, Chen Wen Sheng, Zhou Gen Xu
Institute of Cardiovascular Surgery Xijing Hospital The Fourth Military Medical University Xian, Shaanxi, People's Republic of China.
Asian Cardiovasc Thorac Ann. 2002 Sep;10(3):228-30. doi: 10.1177/021849230201000308.
We report our experience with video-assisted thoracoscopy in the surgical closure of heart septal defects. Nine patients, aged 10 to 26 years, underwent operation for closure of an atrial septal defect; and 3, aged 10 to 22 years, for closure of a ventricular septal defect. Three minithoracotomies with a diameter of 2 to 3 cm were made in the fourth intercostal space of the right parasternum and the fourth and seventh intercostal spaces of the right middle axillary line, respectively. Through the openings and guided by a thoracoscope, a catheter was inserted into the superior vena cava, femorofemoral extracorporeal circulation was built, the aorta was crossclamped, and the myocardium was protected by cold cardioplegia. The right atrium was opened, and the defect was exposed with a traction suture. Primary closure of defects was performed successfully in all patients. The duration of aortic crossclamping and extracorporeal circulation ranged from 11 to 56 minutes and from 50 to 168 minutes, respectively. Postoperatively, cardiac murmur disappeared and echocardiograms showed no residual shunt. Repair of heart septal defects can be completely done with the assistance of video-assisted thoracoscopy, offering a new option with minimal incision.
我们报告了电视辅助胸腔镜手术闭合心脏间隔缺损的经验。9例年龄在10至26岁的患者接受了房间隔缺损闭合手术；3例年龄在10至22岁的患者接受了室间隔缺损闭合手术。分别在右胸骨旁第四肋间以及右腋中线第四和第七肋间做了三个直径为2至3厘米的小切口。通过这些切口并在胸腔镜引导下，将导管插入上腔静脉，建立股股体外循环，夹闭主动脉，并用冷心脏停搏液保护心肌。打开右心房，用牵引缝线暴露缺损。所有患者均成功完成缺损的一期闭合。主动脉夹闭和体外循环时间分别为11至56分钟和50至168分钟。术后，心脏杂音消失，超声心动图显示无残余分流。借助电视辅助胸腔镜可以完全完成心脏间隔缺损的修复，提供了一种切口最小的新选择。
