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非体外循环下经胸微创外科手术(OPOTTMIS)治疗单纯先天性心脏病(房间隔缺损、室间隔缺损和动脉导管未闭)附210例连续病例报告:单中心经验

Off-pump occlusion of trans-thoracic minimal invasive surgery (OPOTTMIS) on simple congenital heart diseases (ASD, VSD and PDA) attached consecutive 210 cases report: a single institute experience.

作者信息

Guo Qing-Kui, Lu Zhi-Qian, Cheng Shao-Fei, Cao Yong, Zhao Yong-Hong, Zhang Cheng, Zhang Yue-Li

机构信息

Department of Cardio-thoracic Surgery, Shanghai NO,6 People Hospital Affiliated Shanghai Jiao Tong University, NO, 600 Yishan Road, Shanghai, 86: 200233, China.

出版信息

J Cardiothorac Surg. 2011 Apr 13;6:48. doi: 10.1186/1749-8090-6-48.

Abstract

OBJECTIVE

This paper intends to report our experiences by using an operation of off-pump occlusion of trans-thoracic minimal invasive surgery (OPOTTMIS) on the treatment of consecutive 210 patients with simple congenital heart diseases (CHD) including atrial septal defect (ASD), ventricular septal defect (VSD) and patent ductus arteriosus (PDA).

METHODS

The retrospective clinical data of OPOTTMIS in our institute were collected and compared to other therapeutic measures adopted in the relevant literatures. After operation, all the patients received electrocardiography (ECG) and echocardiography (echo) once a month within the initial 3 months, and no less than once every 3 ~ 6 months later.

RESULTS

The successful rate of the performed OPOTTMIS operation was 99.5%, the mortality and complication incidence within 72 hours were 0.5% and 4.8%, respectively. There were no major complications during peri-operation such as cardiac rupture, infective endocarditis, strokes, haemolysis and thrombosis. The post-operation follow-up outcomes by ECG and echo checks of 3 months to 5 years showed that there were no III° AVB, no obvious Occluder migration and device broken and no moderate cardiac valve regurgitation, except 1 VSD and 1 PDA with mild residual shunts, and 2 PDA with heart expansion after operation. However, all the patients' heart functions were in class I~II according to NYH standard.

CONCLUSION

The OPOTTMIS is a safe, less complex, feasible and effective choice to selected simple CHD patients with some good advantages and favorable short-term efficacies.

摘要

目的

本文旨在报告我们采用经胸微创非体外循环封堵术(OPOTTMIS)治疗连续210例单纯先天性心脏病(CHD)患者的经验,这些患者包括房间隔缺损(ASD)、室间隔缺损(VSD)和动脉导管未闭(PDA)。

方法

收集我院OPOTTMIS的回顾性临床资料,并与相关文献中采用的其他治疗措施进行比较。术后,所有患者在最初3个月内每月接受一次心电图(ECG)和超声心动图(echo)检查,此后每3至6个月至少检查一次。

结果

所实施的OPOTTMIS手术成功率为99.5%,72小时内的死亡率和并发症发生率分别为0.5%和4.8%。围手术期未发生心脏破裂、感染性心内膜炎、中风、溶血和血栓形成等重大并发症。术后3个月至5年的心电图和超声心动图检查随访结果显示,除1例VSD和1例PDA有轻度残余分流,2例PDA术后有心脏扩大外,无III°房室传导阻滞,无明显封堵器移位和装置破损,无中度心脏瓣膜反流。然而,根据NYH标准,所有患者的心功能均为I~II级。

结论

对于部分选择的单纯CHD患者,OPOTTMIS是一种安全、操作相对简单、可行且有效的选择,具有一些良好的优势和较好的短期疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2bbd/3090330/e3ebbd891d6d/1749-8090-6-48-1.jpg

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