Kimura M, Kitasato K, Kamatani M, Fujino T
Division of Cardiovascular Surgery, Fukuoka University School of Medicine.
Fukuoka Igaku Zasshi. 1992 Feb;83(2):57-61.
Biatrial transseptal approach (Dubost's incision) was performed 54 times on 47 patients from November 1973 to December 1982 at National Fukuoka Higashi Hospital in Japan. The patients consisted of 19 males and 28 females, with ages ranging from 14 to 66 (mean 45.9 years). Forty-four out of 47 cases had rheumatic heart disease while one had endocardial cushion defect, one had Lutembacher's syndrome, and one had left atrial myxoma. Preoperative electrocardiograph showed atrial fibrillation in 37 cases (78.7%) and normal sinus rhythm in 10 cases (21.3%). The follow-ups of the patients were a minimum of 8 years and a maximum of 16 years (mean 9.6 years) with 97.8% completion. Cumulative follow-up period was 448.9 patient years. Postoperatively, atrial fibrillation persisted in all except two. In those patients, normal sinus rhythm was observed until postoperative six months and seven years, respectively. Normal sinus rhythm persisted in six cases, and changed into junctional rhythm in four. One of them changed into atrial fibrillation at 10.6 years postoperatively. We conclude that Dubost's incision provides an excellent operative field for mitral and tricuspid valve surgery without serious internodal conduction disturbances.
1973年11月至1982年12月期间，日本福冈东国立医院对47例患者进行了54次双房经房间隔入路（杜博斯特切口）手术。患者包括19名男性和28名女性，年龄在14岁至66岁之间（平均45.9岁）。47例患者中，44例患有风湿性心脏病，1例患有心内膜垫缺损，1例患有鲁滕巴赫综合征，1例患有左心房黏液瘤。术前心电图显示37例（78.7%）为心房颤动，10例（21.3%）为正常窦性心律。患者的随访时间最短为8年，最长为16年（平均9.6年），随访完成率为97.8%。累积随访时间为448.9患者年。术后，除2例患者外，其余患者心房颤动均持续存在。在这2例患者中，分别在术后6个月和7年观察到正常窦性心律。6例患者窦性心律持续正常，4例转变为交界性心律。其中1例在术后10.6年转变为心房颤动。我们得出结论，杜博斯特切口为二尖瓣和三尖瓣手术提供了良好的手术视野，且不会引起严重的结间传导障碍。
