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微创心脏瓣膜手术

Minimally Invasive Heart Valve Surgery.

作者信息

Bouhout Ismail, Morgant Marie-Catherine, Bouchard Denis

机构信息

Department of Cardiovascular Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada.

Department of Cardiovascular Surgery, Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada.

出版信息

Can J Cardiol. 2017 Sep;33(9):1129-1137. doi: 10.1016/j.cjca.2017.05.014. Epub 2017 May 25.

Abstract

Minimally invasive valve surgery represents a recent and significant advance in modern heart surgery. Indeed, many less invasive approaches for both the aortic and mitral valves have been developed in the past 2 decades. These procedures were hypothesized to result in less operative trauma, which might translate into better patient outcomes. However, this clinical benefit remains controversial in the literature. The aim of this review is to discuss the evidence surrounding minimally invasive heart valve surgery in the current era. A systematic search of the literature from 2006-2016 was performed looking for articles reporting early or late outcomes after minimally invasive valve surgery. Less invasive valve surgery is safe and provides long-term surgical outcomes similar to those of standard sternotomy. In addition, these approaches result in a reduction in overall hospital length of stay and may mitigate the risk of early morbidity-mainly postoperative bleeding, transfusions, and ventilation duration.

摘要

微创瓣膜手术是现代心脏手术中一项近期取得的重大进展。事实上,在过去20年里已经开发出了许多针对主动脉瓣和二尖瓣的侵入性较小的手术方法。这些手术被认为可以减少手术创伤,这可能转化为更好的患者预后。然而,这种临床益处在文献中仍存在争议。本综述的目的是讨论当前时代围绕微创心脏瓣膜手术的证据。对2006年至2016年的文献进行了系统检索,以寻找报告微创瓣膜手术后早期或晚期结果的文章。侵入性较小的瓣膜手术是安全的,并且提供与标准胸骨切开术相似的长期手术结果。此外,这些方法可缩短总体住院时间,并可能降低早期发病风险,主要是术后出血、输血和通气时间。

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