You Bin, Gao Feng, Li Ping, Xu Yi, Xu Li-li, Liu Shuo, Li Guang, Qin Guang-ning
Department of Cardiac Surgery, Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Zhonghua Yi Xue Za Zhi. 2012 Oct 30;92(40):2859-61.
To compare the perioperative outcomes of minimally invasive versus conventional aortic valve replacement.
Between June 2010 and January 2012, 39 patients underwent isolated aortic valve replacement (minimally invasive: n=24, conventional: n=15) at our department. Gender, age, New York Heart Association class, valvular size, valvular type, cardiopulmonary bypass duration, aortic cross-clamping duration, total operative duration (skin incision to skin suture), ventilation time, intensive care unit stay, blood loss volume, blood transfusion volume, left ventricle ejection fraction, perioperative complications, length of incision, hospital stay and hospital costs were used.
There was no case of death or reoperation for bleeding. No statistically significant differences existed between both groups with respect to perioperative course (both P>0.05). Only cardiopulmonary bypass duration and aortic cross-clamping duration were significantly longer in the minimally invasive group while blood transfusion rate (9/24 vs 12/15, P=0.028) and length of incision ((4.9±0.7) cm vs (28.5±4.7) cm, P=0.000) were significantly lower in the minimally invasive group.
As a safe and reproducible procedure, minimally invasive aortic operation may require a smaller incision and achieve better cosmetic outcomes with a lesser volume of blood transfusion.
比较微创与传统主动脉瓣置换术的围手术期结果。
2010年6月至2012年1月期间，我科39例患者接受了单纯主动脉瓣置换术（微创组：n = 24，传统组：n = 15）。记录患者的性别、年龄、纽约心脏病协会心功能分级、瓣膜大小、瓣膜类型、体外循环时间、主动脉阻断时间、总手术时间（皮肤切口至皮肤缝合）、通气时间、重症监护病房停留时间、失血量、输血量、左心室射血分数、围手术期并发症、切口长度、住院时间和住院费用。
无死亡或因出血再次手术的病例。两组围手术期过程无统计学显著差异（均P>0.05）。仅微创组的体外循环时间和主动脉阻断时间明显更长，而微创组的输血率（9/24 vs 12/15，P = 0.028）和切口长度（(4.9±0.7) cm vs (28.5±4.7) cm，P = 0.000）明显更低。
作为一种安全且可重复的手术方法，微创主动脉手术可能切口更小，输血更少，美容效果更好。
