Department of Cardiovascular Surgery, Yodogawa Christian Hospital, Osaka, Osaka, Japan.
Department of Cardiovascular Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan.
Ann Thorac Cardiovasc Surg. 2022 Feb 20;28(1):36-40. doi: 10.5761/atcs.nm.20-00293. Epub 2021 Aug 4.
To discuss minimally invasive cardiac surgery aortic valve replacement (MICS-AVR) approach via anterior thoracotomy using continuous retrograde cardioplegia. Continuous retrograde cardioplegia facilitates excellent continuous homogeneous cooling of the heart during cardiac arrest.
We performed AVR using the proposed method in nine patients between June 2018 and September 2019. The median age of the patients was 73 (range: 43-84) years. The pleural space was entered via anterior thoracotomy. After opening of the right atrium, a retrograde cardioplegic cannula was inserted into the coronary sinus with a purse-string suture. Continuous cold blood retrograde cardioplegia was initiated at 700 mL/h.
Extubation in the operating room was performed in five (56%) patients. No new decreased function of the left and right ventricles was observed in intraoperative transesophageal echography or transthoracic echocardiogram.
MICA-AVR through continuous retrograde cardioplegia is a safe technique.
讨论经前胸壁切口采用持续逆行心脏停搏液灌注的微创心脏外科主动脉瓣置换术（MICS-AVR）方法。持续逆行心脏停搏液可在心脏停搏期间实现心脏的出色、均匀的持续冷却。
我们在 2018 年 6 月至 2019 年 9 月期间对 9 例患者使用提出的方法进行了 AVR。患者的中位年龄为 73 岁（范围：43-84 岁）。经前胸壁切口进入胸腔。打开右心房后，用荷包缝线将逆行灌流管插入冠状窦。以 700 mL/h 的速度开始持续冷血逆行心脏停搏液灌注。
5 例（56%）患者在手术室拔管。术中经食管超声心动图或经胸超声心动图未观察到左、右心室新出现功能减退。
通过持续逆行心脏停搏液的 MICA-AVR 是一种安全的技术。
