Murakami Takashi, Kuinose Masahiko, Masuda Zen-ichi, Shishido Eishun, Tanemoto Kazuo
Department of Cardiovascular Surgery, Iwakuni National Hospital, Iwakuni, Yamaguchi, Japan.
Jpn J Thorac Cardiovasc Surg. 2004 Oct;52(10):456-9. doi: 10.1007/s11748-004-0139-3.
Much more concern is recently paid to the cosmetics when simple congenital heart defect is repaired. Here we present the reversed U-shaped skin incision with lower partial sternotomy for juvenile or adult female patients.
Four patients with atrial septal defect (ASD) and one patient with ventricular septal defect underwent the operation with this method. Patients' ages ranged from 5 to 46 years old.
Postoperative recovery in all cases was uneventful. Only the middle portion of the operative scar was visible when the breast was well developed. The scar was completely covered by the brassiere. A numbness of the upper medial portion of the left breast was recognized in one initial patient, who underwent ASD closure and concomitant right-side Maze procedure, necessitating a wider dissection than that used for other patients.
A reversed U-shaped skin incision with a lower sternotomy could provide relatively comfortable operative fields for cardiac surgeons, and be cosmetically appealing to female patients who require a repair of simple congenital heart defect.
在单纯先天性心脏病修复手术中,近期人们对手术切口美观性愈发关注。在此,我们为青少年或成年女性患者介绍一种采用下部部分胸骨切开术的倒U形皮肤切口法。
5例房间隔缺损(ASD)患者和1例室间隔缺损患者采用此方法接受手术。患者年龄范围为5至46岁。
所有病例术后恢复均顺利。乳房发育良好时,仅手术瘢痕的中间部分可见。瘢痕完全被胸罩覆盖。1例最初接受ASD封堵并同期行右侧迷宫手术的患者,其左乳上内侧部分出现麻木感,该患者手术时的解剖范围比其他患者更广。
下部胸骨切开术联合倒U形皮肤切口可为心脏外科医生提供相对舒适的手术视野,对于需要修复单纯先天性心脏病的女性患者而言,在美观方面具有吸引力。