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比较在心脏跳动时使用心内流入道阻断与体外循环在右心取出肿块或异物中的应用。

Comparison of inflow occlusion on the beating heart with cardiopulmonary bypass in the extraction of a mass lesion or a foreign body from the right heart.

机构信息

Izmir Ataturk Education and Research Hospital, Basin Sitesi, 35360, Izmir, Turkey.

出版信息

Eur J Cardiothorac Surg. 2011 May;39(5):689-92. doi: 10.1016/j.ejcts.2010.08.048. Epub 2010 Oct 8.

Abstract

OBJECTIVE

Two basic surgical techniques exist in the extraction of a mass lesion or a foreign body from the right atrium and/or the right ventricle. These are inflow occlusion of the right heart and with assistance of the cardiopulmonary bypass (CPB). In this study, these two methods were compared.

METHODS

Between May 2001 and April 2010, 15 patients were operated upon for the extraction of a mass lesion or a foreign body from the right heart. Seven patients were operated upon using venous inflow occlusion technique, whereas eight patients were operated upon using CPB. These two groups were evaluated and compared in terms of clinical parameters.

RESULTS

Intracardiac masses or foreign bodies were completely removed by using both methods. Patients who were operated upon using inflow occlusion on beating heart (IOBH) developed no postoperative complication, whereas two patients who were operated upon with CPB developed complications, postoperatively. Moreover, duration of hospital stay, duration of intensive care unit (ICU) stay, and intubation time were significantly lower in the IOBH group when compared with the CPB group. In the CPB group, the amount of blood transfused was significantly higher.

CONCLUSIONS

In suitable patient groups, the IOBH technique could be safely performed by experienced centers.

摘要

目的

从右心房和/或右心室提取肿块或异物有两种基本的手术技术。这些是右心的流入道阻断和心肺旁路(CPB)的辅助。在这项研究中,比较了这两种方法。

方法

2001 年 5 月至 2010 年 4 月,15 名患者因右心肿块或异物而接受手术。7 名患者采用静脉流入阻断技术进行手术,8 名患者采用 CPB 进行手术。评估并比较这两组患者的临床参数。

结果

两种方法均能完全清除心内肿块或异物。采用心脏跳动下流入阻断(IOBH)的患者术后无并发症,而采用 CPB 的 2 名患者术后出现并发症。此外,与 CPB 组相比,IOBH 组的住院时间、重症监护病房(ICU)停留时间和插管时间明显缩短。CPB 组的输血量明显增加。

结论

在合适的患者群体中,有经验的中心可以安全地进行 IOBH 技术。

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