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机器人二尖瓣修复术的随访:中国单中心经验。

Follow-Up of Robotic Mitral Valve Repair: A Single Tertiary Institution Experience in China.

机构信息

Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.

出版信息

Comput Math Methods Med. 2022 May 21;2022:1997371. doi: 10.1155/2022/1997371. eCollection 2022.

Abstract

Surgical treatment of mitral valve diseases has become minimally invasive. This study analyzed the follow-up results of patients after mitral valve repairs (MVRep) using the da Vinci robot. The clinical data of patients who underwent minimally invasive MVRep using the da Vinci robot between January 2016 and June 2021 and completed follow-ups were prospectively collected. All operations were performed by the same surgeon and assistants. The data of a total of 120 patients were available for analysis, including 78 males (65%) and 42 females aged 49.9 ± 12.1 years (range, 19-73 years). Among them, there were 30 cases (25%) of mitral valve prolapse, 87 cases (72.5%) of mitral regurgitation, and 40 cases of combined tricuspid regurgitation. Edwards Physio II annuloplasty rings were implanted intraoperatively, followed by continuous sutures. The intraoperative cardiopulmonary bypass time was 152.32 ± 45.77 min, and the aortic occlusion time was 95.13 ± 5.64 min. After surgery, patients were followed up regularly with echocardiography with a follow-up period of 3-57 months postoperatively. One patient died in the early stage, and five patients required sternotomy due to postoperative bleeding. Follow-up transesophageal echocardiography showed that the end-systolic diameter, end-diastolic diameter, and ejection fraction of the left ventricular all improved after surgery. Among Chinese patients, MVRep using the da Vinci robot is a safe and effective surgical approach.

摘要

二尖瓣疾病的外科治疗已变得微创化。本研究分析了使用达芬奇机器人进行二尖瓣修复(MVRep)后的患者的随访结果。前瞻性收集了 2016 年 1 月至 2021 年 6 月期间使用达芬奇机器人进行微创 MVRep 并完成随访的患者的临床数据。所有手术均由同一位外科医生和助手完成。共有 120 名患者的数据可用于分析,其中 78 名男性(65%)和 42 名女性年龄为 49.9±12.1 岁(范围为 19-73 岁)。其中,30 例(25%)为二尖瓣脱垂,87 例(72.5%)为二尖瓣反流,40 例为三尖瓣反流合并。术中植入爱德华兹生理 II 瓣环成形环,随后进行连续缝合。术中体外循环时间为 152.32±45.77min,主动脉阻断时间为 95.13±5.64min。手术后,患者定期进行超声心动图随访,随访时间为术后 3-57 个月。1 例患者早期死亡,5 例患者因术后出血需要行胸骨切开术。随访经食管超声心动图显示,左心室收缩末期直径、舒张末期直径和射血分数均在手术后得到改善。在中国患者中,使用达芬奇机器人进行 MVRep 是一种安全有效的手术方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/431d/9148248/8f08fa9e1062/CMMM2022-1997371.001.jpg

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