Walther Thomas, Falk Volkmar, Mohr Friedrich W
St. Jude Medical, Inc.
Curr Probl Cardiol. 2006 Jun;31(6):399-437. doi: 10.1016/j.cpcardiol.2006.02.002.
Heart valve surgery evolved since the early 1960s toward routine clinical application with good patient outcome. Different surgical techniques and valve prostheses have been developed. Thus standard procedures were continuously established. The different surgical procedures have now gained widespread clinical acceptance with good patient outcomes. Aortic valve stenosis and mitral valve incompetence are the most frequently acquired heart valve lesions in the western communities. Usually such lesions reach clinical significance in patients during their fifth to eighth decade of life. Standard surgical techniques of aortic valve repair and mitral valve replacement or repair result in persistent cure of the disease. Surgical access was gained using conventional lateral thoracotomies in the early days and later on using median sternotomy. Minimally invasive techniques, mostly by a partial sternotomy for the aortic and a lateral minithoracotomy for the mitral position, have been increasingly applied to improve patient outcome since the mid 1990s. At specialized centers these techniques have evolved as clinical standard allowing all different valve procedures to be safely performed. Patient recovery is fast leading to a significant improvement in the individual's quality of life. Minimally invasive valve surgery can be considered the standard approach and will reach more widespread clinical application.
自20世纪60年代初以来，心脏瓣膜手术不断发展，逐渐应用于常规临床治疗，并取得了良好的患者治疗效果。人们开发了不同的手术技术和瓣膜假体。因此，标准手术程序不断建立。目前，不同的手术程序已在临床上广泛应用，并取得了良好的患者治疗效果。在西方社会，主动脉瓣狭窄和二尖瓣关闭不全是最常见的后天性心脏瓣膜病变。通常，这些病变在患者50至80岁时具有临床意义。主动脉瓣修复和二尖瓣置换或修复的标准手术技术可使疾病得到根治。早期通过传统的侧胸壁切开术进行手术，后来采用正中胸骨切开术。自20世纪90年代中期以来，微创技术越来越多地被应用，主要是通过部分胸骨切开术治疗主动脉瓣病变，通过侧胸壁小切口治疗二尖瓣病变，以改善患者的治疗效果。在专业中心，这些技术已发展成为临床标准，能够安全地进行所有不同的瓣膜手术。患者恢复迅速，个人生活质量得到显著改善。微创瓣膜手术可被视为标准方法，并将在临床上得到更广泛的应用。
