Raja Shahzad G, Benedetto Umberto
Department of Cardiac Surgery, Harefield Hospital, London, UK.
J Thorac Dis. 2013 Nov;5 Suppl 6(Suppl 6):S654-7. doi: 10.3978/j.issn.2072-1439.2013.09.23.
Surgical aortic valve replacement (AVR) via complete median sternotomy is a safe and time-tested technique associated with excellent short- and long-term outcome. Over the last two decades, different minimally-invasive approaches for AVR have been developed and are increasingly being utilized. All these approaches have been developed with the main objective of decreased invasiveness and less surgical trauma. Advantages of minimal invasive AVR have been shown as better cosmesis, shorter ventilation time, decreased blood loss, shorter intensive care unit and hospital length of stay, and less postoperative pain with mortality and morbidity comparable to conventional complete median sternotomy. One well-recognized but less practiced surgical technique for surgical AVR is the complete median sternotomy via limited skin incision. This review article provides a detailed insight into the technical aspects, outcomes, advantages and disadvantages associated with minimal access AVR via limited skin incision and complete median sternotomy.
经完全正中胸骨切开术进行外科主动脉瓣置换术（AVR）是一种安全且经过时间考验的技术，具有出色的短期和长期效果。在过去二十年中，已开发出不同的微创AVR方法并越来越多地被采用。所有这些方法的开发主要目的都是降低侵入性和减少手术创伤。微创AVR的优势已被证明包括更好的美容效果、更短的通气时间、减少失血、缩短重症监护病房和住院时间，以及术后疼痛减轻，死亡率和发病率与传统的完全正中胸骨切开术相当。一种公认但较少应用的外科AVR手术技术是经有限皮肤切口进行完全正中胸骨切开术。这篇综述文章详细介绍了经有限皮肤切口和完全正中胸骨切开术进行微创AVR的技术方面、结果、优缺点。
