Chirichilli Ilaria, D'Ascoli Riccardo, Rose David, Frati Giacomo, Greco Ernesto
Department of Cardiovascular, Respiratory, Nephrological, Anesthesiological, and Geriatric Sciences, Policlinico Umberto I-Sapienza University of Rome, 00161 Rome, Italy;
J Thorac Dis. 2013 Nov;5 Suppl 6(Suppl 6):S680-5. doi: 10.3978/j.issn.2072-1439.2013.10.14.
The aim of this review is to focus the attention on the "state of the art" of port-access and video-assisted mitral valve surgery appraising the results compared to the traditional approach, describing different technical strategies and analyzing how to avoid and manage its related complications concomitantly elucidating which procedure is associated with the most favorable risk-benefit and cost-benefit profile. Our default strategy is to use the minimally invasive approach combining video-assisted right mini-thoracotomy with endo-cardiopulmonary bypass and endo-aortic balloon occlusion (EBO) whenever possible. This choice is supported by the evidence that, after an initial learning curve, it is a safe and effective approach in terms of short- and long-term results, mainly for redo operations and even for elderly patients with moderately elevated peri-operative risk.
本综述的目的是聚焦于端口入路和电视辅助二尖瓣手术的“最新技术水平”，评估与传统手术方法相比的结果，描述不同的技术策略，并分析如何避免和处理其相关并发症，同时阐明哪种手术具有最有利的风险效益和成本效益特征。我们的默认策略是尽可能采用微创方法，将电视辅助右胸小切口与体外循环和主动脉内球囊阻断（EBO）相结合。这一选择得到了以下证据的支持：经过最初的学习曲线后，就短期和长期结果而言，这是一种安全有效的方法，主要适用于再次手术，甚至适用于围手术期风险中度升高的老年患者。
