Sebastian Vinod A, Guleserian Kristine J, Leonard Steven R, Forbess Joseph M
Department of Cardiothoracic Surgery, UT Southwestern Medical Center at Dallas, Dallas, TX 75390, USA.
Interact Cardiovasc Thorac Surg. 2009 Nov;9(5):819-21. doi: 10.1510/icvts.2009.209593. Epub 2009 Aug 14.
We report our experience with repair of a variety of congenital heart defects utilizing a ministernotomy incision. A ministernotomy was used in 79 patients with a variety of congenital heart diseases from November 2004 to August 2007. Patients included 36 males and 43 females with ages ranging from 1 month to 122 months (median age, 22 months). The weight ranged from 3.5 kg to 40 kg (median weight, 10.9 kg). There were no deaths, and one conversion to full median sternotomy (1/79, 1.3%). The median cardiopulmonary bypass time was 59 min, and median aortic cross-clamp time was 38 min. One patient underwent atrial septal defect (ASD) repair with fibrillatory arrest time of 35 min. The operating time ranged from 103 min to 312 min (median operating time, 168 min). The intensive care unit (ICU) stay ranged from 1 to 21 days (median ICU stay, 1 day) and the hospital stay ranged from 2 to 56 days (median hospital stay, 4 days). There were no reinterventions for residual cardiac defects. We demonstrate the safety and efficacy of ministernotomy for the correction of a range of congenital heart defects with improved cosmetic results.
我们报告了使用胸骨上段小切口修复各种先天性心脏缺陷的经验。2004年11月至2007年8月,79例患有各种先天性心脏病的患者接受了胸骨上段小切口手术。患者包括36名男性和43名女性,年龄从1个月至122个月(中位年龄22个月)。体重范围为3.5千克至40千克(中位体重10.9千克)。无死亡病例,1例转为全胸骨正中切口(1/79,1.3%)。中位体外循环时间为59分钟,中位主动脉阻断时间为38分钟。1例患者在房颤停搏时间为35分钟的情况下接受了房间隔缺损(ASD)修复。手术时间从103分钟至312分钟(中位手术时间168分钟)。重症监护病房(ICU)住院时间为1至21天(中位ICU住院时间1天),住院时间为2至56天(中位住院时间4天)。未因残留心脏缺陷进行再次干预。我们证明了胸骨上段小切口在矫正一系列先天性心脏缺陷方面的安全性和有效性,且美容效果更佳。