经右侧腋下小切口垂直入路修复部分房室间隔缺损
Repair of partial atrioventricular septal defect through a minimal right vertical infra-axillary thoracotomy.
作者信息
Yang Xiubin, Wang Dongjin, Wu Qingyu
机构信息
Department of Cardiovascular Surgery, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Peking, Beijing, China.
出版信息
J Card Surg. 2003 May-Jun;18(3):262-4. doi: 10.1046/j.1540-8191.2003.02042.x.
OBJECTIVE
To report a new minimally invasive and cosmetic approach for partial atrioventricular septal defect (PAVSD) repair.
METHODS
From November 1997 to January 2000, six patients with a mean age of 19.2 +/- 7.7 years underwent minimal right vertical infra-axillary thoracotomy for PAVSD repair. Left atrioventricular (AV) valve regurgitation was assessed on the beating heart before and after valvuloplasty. Commissuroplasty of the left AV valve and atrial septum repair were done in all patients.
RESULTS
There were no operative or late mortality, and no morbidity directly related to the thoracotomy approach. The average length of the incision was 8.3 +/- 131 cm. The arrest times averaged 32.8 +/- 8.3 minutes, and the cardiopulmonary bypass times averaged 66.0 +/- 9.0 minutes. One patient had a mild to moderate left AV valve regurgitation postoperatively. All patients were free of symptoms during the follow-up.
CONCLUSION
The minimal right vertical infra-axillary thoracotomy is a safer, more cosmetic and less invasive approach than median sternotomy for the repair of PAVSD.
目的
报告一种用于部分房室间隔缺损（PAVSD）修复的新型微创且美观的手术方法。
方法
1997年11月至2000年1月，6例平均年龄为19.2±7.7岁的患者接受了经右腋下垂直小切口进行PAVSD修复手术。在瓣膜成形术前和术后，在心脏跳动时评估左房室（AV）瓣反流情况。所有患者均进行了左房室瓣连合部切开术和房间隔修复术。
结果
无手术死亡或晚期死亡病例，也没有与开胸手术方法直接相关的并发症。切口平均长度为8.3±1.31厘米。阻断时间平均为32.8±8.3分钟，体外循环时间平均为66.0±9.0分钟。1例患者术后有轻度至中度左房室瓣反流。所有患者在随访期间均无症状。
结论
对于PAVSD修复，经右腋下垂直小切口手术比正中胸骨切开术更安全、更美观且创伤更小。
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