Vanoverbeke H, Van Belleghem Y, Francois K, Caes F, Bové T, Van Nooten G
Department of Cardiac Surgery, University Hospital Gent, Gent, Belgium.
Acta Chir Belg. 2004 Aug;104(4):440-4.
to determine the advantages and/or risks of minimal access aortic valve replacement compared to standard sternotomy procedure.
from January 1997 to December 2001, 271 consecutive adult patients underwent isolated aortic valve replacement of which 174 underwent a minimal access procedure (Group 1) and 97 a standard procedure (Group 2). The preoperative variables of both groups were comparable. Retrospective analysis of postoperative outcome was performed.
follow-up was complete and ranged from 6 months to 4 years. Overall in-hospital mortality was 3.3% (respectively 2.8 and 4.1%). No statistical difference was noted regarding operative time variables, mortality rate and hospital stay. There was a significant higher incidence of revision (p = 0.018) and late pericardial effusion (p = 0.022) in the minimal access group. Also trends were in favour of the standard group for incidence of postoperative pneumothorax and pericarditis constrictiva.
minimal access aortic valve replacement is a safe and reliable technique, but carries the risk of incision-related morbidity. Proper patient selection and perioperative management is mandatory.
确定与标准胸骨切开术相比，微创主动脉瓣置换术的优势和/或风险。
1997年1月至2001年12月，271例连续成年患者接受单纯主动脉瓣置换术，其中174例行微创术（第1组），97例行标准术（第2组）。两组术前变量具有可比性。对术后结果进行回顾性分析。
随访完整，时间从6个月至4年。总体住院死亡率为3.3%（分别为2.8%和4.1%）。手术时间变量、死亡率和住院时间方面未发现统计学差异。微创组翻修发生率（p = 0.018）和晚期心包积液发生率（p = 0.022）显著更高。术后气胸和缩窄性心包炎发生率方面也有趋势显示标准组更优。
微创主动脉瓣置换术是一种安全可靠的技术，但存在与切口相关的发病风险。必须进行恰当的患者选择和围手术期管理。
