Ozawa Tatsuya, Kawasaki Yusuke, Suenaga Etsuro
Divison of Cardiovascular Surgery, Kansai Electric Power Hospital, Osaka, Japan.
Kyobu Geka. 2021 May;74(5):362-365.
Cardiac surgery for elder patients should be minimally invasive because of their frailty and concomitant multiple chronic diseases. We performed aortic valve replacement (AVR) via upper hemisternotomy (UHS) on an 85-year-old patient who suffered from severe aortic regurgitation with dobutamine support. The postoperative course was uneventful. AVR via UHS is safer than that via right axiallary thoracotomy AVR with shorter aortic cross-clamp time, shorter cardiopulmonary bypass time and fewer complications. AVR via UHS makes ambulation and rehabilitation easier than AVR via full sternotomy, because of thoracic stability. It is more effective and should be more prevalent as minimally invasive cardiac surgery for eldery patients with frailty.
由于老年患者身体虚弱且常伴有多种慢性疾病，心脏手术应尽量采用微创方式。我们对一名85岁患有严重主动脉瓣反流且需多巴酚丁胺支持的患者进行了经上半胸骨切开术（UHS）的主动脉瓣置换术（AVR）。术后过程顺利。经UHS的AVR比经右腋下开胸AVR更安全，主动脉阻断时间更短，体外循环时间更短，并发症更少。由于胸廓稳定性，经UHS的AVR比经全胸骨切开术的AVR使患者行走和康复更容易。作为针对身体虚弱老年患者的微创心脏手术，它更有效且应更普遍应用。
