多孔型房间隔瘤的微创修复
Minimally invasive repair of fenestrated atrial septal aneurysm.
作者信息
Naficy Seph, Klemis James E, Gubin Steven S, Funderburg William R, Craig John M
机构信息
Cardiovascular Surgery Clinic, Memphis, TN, USA.
Stern Cardiovascular Foundation, Memphis, TN, USA.
出版信息
J Vis Surg. 2016 Jan 27;2:21. doi: 10.3978/j.issn.2221-2965.2015.12.05. eCollection 2016.
BACKGROUND
Atrial septal aneurysms (ASAs) are uncommon but are associated with significant embolic morbidity when an interatrial communication is present. Although surgical reconstruction has traditionally been approached through a median sternotomy, minimally invasive techniques may be employed to reduce pain and recovery time.
METHODS
We present a video-assisted technique via right inframammary minithoracotomy utilizing peripheral cannulation for cardiopulmonary bypass. Included is a discussion of surgical tips, potential pitfalls and a description of unique technical aspects that differentiate atrial septal repair from other minimally invasive cardiac operations.
RESULTS
A complete repair of the defect was confirmed by intraoperative transesophageal echocardiography (TEE). The patient made an uncomplicated recovery and was discharged home within 48 hours of surgery.
CONCLUSIONS
Minimally invasive repair of an ASA utilizing peripheral cannulation for cardiopulmonary bypass and a right inframammary incision can be accomplished with satisfactory technical success and recovery time.
背景
房间隔瘤（ASAs）并不常见，但当存在房间隔交通时，与显著的栓塞性发病率相关。尽管传统上手术重建是通过正中胸骨切开术进行的，但也可采用微创技术来减轻疼痛并缩短恢复时间。
方法
我们介绍一种通过右乳房下小切口开胸术并利用外周插管进行体外循环的视频辅助技术。其中包括手术技巧、潜在陷阱的讨论以及将房间隔修复与其他微创心脏手术区分开来的独特技术方面的描述。
结果
术中经食管超声心动图（TEE）证实缺损得到完全修复。患者恢复顺利，术后48小时内出院。
结论
利用外周插管进行体外循环并采用右乳房下切口对房间隔瘤进行微创修复，技术成功率和恢复时间令人满意。
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