Tang Mariann, Klaaborg Kaj-Erik, Egeblad Henrik, Mølgaard Henning, Poulsen Steen Hvidtfeldt, Smerup Morten, Wierup Per
Arhus Universitetshospital, Skejby.
Ugeskr Laeger. 2009 Apr 6;171(15):1285-8.
We have experienced a growing demand from patients for minimally invasive cardiac surgery.
From March 2006 through November 2007 we performed endoscopic mitral valve surgery in 30 patients (20 mitral valve repairs, eight mitral valve replacements and two extirpations of mitral valve fibroelstoma). Seven patients had concomitant surgery, including cryomaze to eliminate atrial fibrillation and/or closure of an atrial septal defect (ASD). Median preoperative functional class was New York Heart Association (NYHA) II and all patients had severe mitral valve regurgitation. The mean age was 58.0 +/-3 years and 27% of the patients were females.
The procedure was performed successfully in all patients with no conversion to sternotomy, while postoperative morbidity was very limited and no mortality was seen. Early echocardiographic follow-up showed fully competent mitral valve repairs.
Endoscopic mitral valve surgery is an attractive alternative to conventional sternotomy with an attractive cosmetic result. This can be obtained without compromising quality or safety. This paper confirms that endoscopic mitral valve surgery is feasible and it provides the least invasive operative approach. The technique is currently our primary surgical approach for mitral valve disease.
我们发现患者对微创心脏手术的需求日益增加。
2006年3月至2007年11月,我们对30例患者进行了内镜二尖瓣手术(20例二尖瓣修复术、8例二尖瓣置换术和2例二尖瓣纤维弹性瘤切除术)。7例患者接受了同期手术,包括冷冻迷宫术以消除房颤和/或闭合房间隔缺损(ASD)。术前功能分级中位数为纽约心脏协会(NYHA)II级,所有患者均有严重二尖瓣反流。平均年龄为58.0±3岁,27%的患者为女性。
所有患者手术均成功,无一例转为胸骨切开术,术后发病率极低,无死亡病例。早期超声心动图随访显示二尖瓣修复功能完全良好。
内镜二尖瓣手术是传统胸骨切开术的一种有吸引力的替代方法,具有诱人的美容效果。在不影响质量或安全性的情况下即可实现。本文证实内镜二尖瓣手术是可行的,且提供了侵入性最小的手术方法。该技术目前是我们治疗二尖瓣疾病的主要手术方法。