Kim Ji Eon, Jung Sung-Ho, Kim Gwan Sic, Kim Joon Bum, Choo Suk Jung, Chung Cheol Hyun, Lee Jae Won
Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea.
Korean J Thorac Cardiovasc Surg. 2013 Apr;46(2):93-7. doi: 10.5090/kjtcs.2013.46.2.93. Epub 2013 Apr 9.
Minimally invasive cardiac surgery has emerged as an alternative to conventional open surgery. This report reviews our experience with atrial septal defect using the da VinciTM surgical robot system.
This retrospective study included 50 consecutive patients who underwent atrial septal defect repair using the da VinciTM surgical robot system between October 2007 and May 2011. Among these, 13 patients (26%) were approached through a totally endoscopic approach and the others by mini-thoracotomy. Nineteen patients had concomitant procedures including tricuspid annuloplasty (n=10), mitral valvuloplasty (n=9), and maze procedure (n=4). The mean follow-up duration was 16.9±10.4 months.
No remnant interatrial shunt was detected by intraoperative or postoperative echocardiography. The atrial septal defects were mainly repaired by Gore-Tex patch closure (80%). There was no operative mortality or serious surgical complications. The aortic cross clamping time and cardiopulmonary bypass time were 74.1±32.2 and 157.6±49.7 minutes, respectively. The postoperative hospital stay was 5.5±3.3 days.
The atrial septal defect repair with concomitant procedures like mitral valve repair or tricuspid valve repair using the da VinciTM system is a feasible method. In addition, in selected patients, complete port access can be helpful for better cosmetic results and less musculoskeletal injury.
微创心脏手术已成为传统开放手术的一种替代方法。本报告回顾了我们使用达芬奇手术机器人系统治疗房间隔缺损的经验。
这项回顾性研究纳入了2007年10月至2011年5月期间连续50例使用达芬奇手术机器人系统进行房间隔缺损修复的患者。其中,13例(26%)采用完全内镜入路,其余采用小切口开胸手术。19例患者同时进行了其他手术,包括三尖瓣成形术(n = 10)、二尖瓣成形术(n = 9)和迷宫手术(n = 4)。平均随访时间为16.9±10.4个月。
术中或术后超声心动图均未检测到残余房间隔分流。房间隔缺损主要通过Gore-Tex补片修补(80%)。无手术死亡或严重手术并发症。主动脉阻断时间和体外循环时间分别为74.1±32.2分钟和157.6±49.7分钟。术后住院时间为5.5±3.3天。
使用达芬奇系统进行房间隔缺损修复并同时进行二尖瓣或三尖瓣修复等手术是一种可行的方法。此外,对于部分患者,完全端口入路有助于获得更好的美容效果和减少肌肉骨骼损伤。