Mack M J
Medical City Hospital, Cardiopulmonary Research Science and Technology Institute, Dallas, TX 75230, USA.
Surg Endosc. 2006 Apr;20 Suppl 2:S488-92. doi: 10.1007/s00464-006-0110-8. Epub 2006 Mar 23.
Cardiac surgery has been the last of the surgical specialties to embrace the principles of minimal invasiveness. The complexity and invasiveness of the procedures have presented both a problem and an opportunity to make the procedures less invasive. Beginning with initial attempts at coronary artery bypass surgery through limited access with and without robotics, a number of other cardiac procedures currently are being performed by minimally invasive approaches. These include mitral valve repair, transapical aortic valve implant, limited access, and totally endoscopic pulmonary vein isolation for the treatment of atrial fibrillation and the treatment of aortic aneurysmal disease by thoracic endografting. The experience with less invasive surgery in other specialties has served as cross-fertilization for minimally invasive cardiac surgery.
心脏外科一直是最后一批接受微创原则的外科专业领域。手术操作的复杂性和侵入性既带来了问题，也提供了使手术侵入性降低的机遇。从最初尝试通过有限切口并借助或不借助机器人技术进行冠状动脉搭桥手术开始，目前许多其他心脏手术也正在采用微创方法进行。这些手术包括二尖瓣修复、经心尖主动脉瓣植入、有限切口以及完全内镜下肺静脉隔离以治疗心房颤动，还有通过胸段腔内移植物植入治疗主动脉瘤疾病。其他专业领域的微创手术经验为微创心脏手术提供了借鉴。
