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东卡罗来纳大学的机器人二尖瓣手术:6年经验

Robotic mitral surgery at East Carolina University: a 6 year experience.

作者信息

Rodríguez Evelio, Kypson Alan P, Moten Simon C, Nifong L Wiley, Chitwood W Randolph

机构信息

Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, NC 27858, USA.

出版信息

Int J Med Robot. 2006 Sep;2(3):211-5. doi: 10.1002/rcs.80.

Abstract

BACKGROUND

Robotic mitral valve repair using the da Vinci telemanupilation system has become the standard of care at many centres worldwide. We perform the first robotic MV repair in the United States in the year 2000. This article reviews our 6 year experience and current technique of robotic MV repair as well as future trends in the field.

METHODS

Retrospective review of our initial 200 robotic MV repairs. Patient demographics, operative times, type of repairs, morbidities, mortality, success of the repair including need for reoperations were reviewed.

RESULTS

The average age was 57 +/- 0.9 years. Average time for CPB was 156 minutes and for cross clamp 119 minutes. There was one operative death (0.5%) with no device related complications. Postoperative TEE demonstrated no MR in 187 (93.5%) patients, trace MR in 6 (3%) patients, moderate MR in 5 (2.5%) patients, and SAM in 2 (1%) patients. Five (2.5%) patients required reoperation for failed repairs.

CONCLUSIONS

Robotic MV repair operations are safe with excellent early results. Follow-up studies are needed to determine repair longevity. We must continue to improve the current technology in order to develop the next generation of tools that will facilitate robotic MV repairs.

摘要

背景

使用达芬奇远程操作手术系统进行机器人二尖瓣修复术已成为全球许多中心的治疗标准。我们于2000年在美国首次开展机器人二尖瓣修复术。本文回顾了我们6年的经验、机器人二尖瓣修复术的当前技术以及该领域的未来趋势。

方法

对我们最初的200例机器人二尖瓣修复术进行回顾性研究。回顾了患者的人口统计学资料、手术时间、修复类型、发病率、死亡率、修复成功率,包括再次手术的必要性。

结果

平均年龄为57±0.9岁。体外循环平均时间为156分钟,主动脉阻断平均时间为119分钟。有1例手术死亡(0.5%),无器械相关并发症。术后经食管超声心动图显示,187例(93.5%)患者无二尖瓣反流,6例(3%)患者有微量二尖瓣反流,5例(2.5%)患者有中度二尖瓣反流,2例(1%)患者有二尖瓣收缩期前移。5例(2.5%)患者因修复失败需要再次手术。

结论

机器人二尖瓣修复手术安全,早期效果良好。需要进行随访研究以确定修复的持久性。我们必须继续改进当前技术,以开发下一代便于机器人二尖瓣修复的工具。

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