Shinfeld Amihay, Kachel Erez, Paz Yoav, Praisman Sergei, Smolinsky Aram K
Department of Cardiac Surgery, Sheba Medical Center, Tel Hashomer, Israel.
Isr Med Assoc J. 2003 Jul;5(7):482-4.
After the introduction of endoscopic techniques to other surgical fields like general surgery, gynecology and thoracic surgery, cardiac surgeons sought their own methods of using minimally invasive techniques.
To examine whether this approach is less invasive and yields better results, more desirable cosmetic results, and a more rapid and complete rehabilitation, maintaining safety, efficacy, and outcome equivalent to those of more established procedures, such as median sternotomy.
From January 2000 to July 2001, 22 patients underwent video-assisted port-access mitral or aortic valve repair or replacement with the Heartport system in our department, and one underwent closure of atrial septal defect.
Intraoperative transesophageal echocardiography revealed excellent functional results. Total operating room time, perfusion time, and cross-clamp time with this technique decreased with our growing experience and remains stable. There were no intraoperative reversals to mid-steronomy, no mortalities, and only one complication 24 hours after surgery.
Thoracoscopic assisted cardiac surgery (via port access) provides all the advantages of minimally invasive surgery, accelerates recovery, decreases pain, and maintains overall surgical efficacy, while avoiding the complications and pathology of mid-sternotomy. For appropriate patients, this is the method of choice in our department.
在内镜技术被引入普通外科、妇科和胸外科等其他外科领域后，心脏外科医生开始探寻自身运用微创技术的方法。
检验这种方法是否创伤更小，能否产生更好的效果、更理想的美容效果以及更快速和完全的康复，同时保持与更成熟的手术（如正中开胸术）相当的安全性、有效性和结果。
2000年1月至2001年7月，我们科室22例患者采用心脏端口系统进行了电视辅助端口入路二尖瓣或主动脉瓣修复或置换，1例患者进行了房间隔缺损封堵术。
术中经食管超声心动图显示功能效果极佳。随着经验的积累，该技术的总手术室时间、灌注时间和阻断时间缩短并保持稳定。术中未转为正中开胸术，无死亡病例，术后仅1例患者出现并发症。
胸腔镜辅助心脏手术（经端口入路）具备微创手术的所有优势，能加速康复、减轻疼痛并维持整体手术效果，同时避免正中开胸术的并发症和病理情况。对于合适的患者，这是我们科室的首选方法。
