Boix-Garibo Ricardo, Uzzaman Mohammed Mohsin, Bapat Vinayak Nilkanth
Department of Cardiothoracic Surgery, St Thomas' Hospital, Guy's & St Thomas' NHS Foundation Trust, London, UK.
Birmingham Children's Hospital, Birmingham, UK.
Interv Cardiol. 2015 Sep;10(3):144-148. doi: 10.15420/ICR.2015.10.03.144.
Minimally invasive aortic valve surgery (MIAVS) has been developed for the last 20 years. The improvements in techniques have permitted cardiac surgeons to perform aortic valve replacement safely and efficiently with minimally incisions. Patients have become older and have multiple comorbidities and this is expected to grow in number. Less-invasive procedures are known to reduce the number of complications, together with smaller incisions, less pain, less blood loss and reduced length of hospital stay. Selective preoperative planning with computed tomography is key to the pre-investigation stage. Hybrid and staged procedures with interventional cardiologists are part of the armamentarium and may be appealing for the present and near future. Despite the nature of demanding procedures and longer learning curve with increased cardiopulmonary bypass times, the outcomes are comparable with same quality as conventional open surgery. Patient recovery is the ultimate purpose of these approaches.
微创主动脉瓣手术(MIAVS)在过去20年中得到了发展。技术的进步使心脏外科医生能够通过最小的切口安全、高效地进行主动脉瓣置换术。患者年龄越来越大且合并多种疾病,预计这一群体数量还会增加。众所周知,侵入性较小的手术可减少并发症数量,同时切口更小、疼痛减轻、失血减少且住院时间缩短。术前利用计算机断层扫描进行选择性规划是术前检查阶段的关键。与介入心脏病专家合作开展的杂交手术和分期手术是现有手段的一部分,在当前及不久的将来可能具有吸引力。尽管这类手术要求高,学习曲线较长,体外循环时间增加,但手术结果与传统开放手术的质量相当。患者康复是这些手术方式的最终目的。