Tian Hang, Chen Yan-Jun, Tian He, Zhang Xiao-Shen, Lu Hua, Shen Si, Wang Hao
Department of Anesthesiology, Guangzhou Women and Children's Medical Center, Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, 510623, PR China.
Department of Anesthesiology, The First Affiliated Hospital, Jinan University, Guangzhou 510630, PR China.
Heliyon. 2023 Apr 23;9(5):e15737. doi: 10.1016/j.heliyon.2023.e15737. eCollection 2023 May.
Anesthesia management of Totally thoracoscopic cardiac surgery (TTCS) has been the subject of much debate and discussion. In this single center retrospective study, we summarize the experience of clinical anesthesia management for TTCS by review the medical records of our medical center and look forward to its future development. In this retrospective study, 103 patients (49 male and 54 female) were enrolled, the mean age was 56.7 ± 14.4 years old. The participants underwent Mitral Valve Replacement (MVR) + Tricuspid Valve Annuloplasty (TVA) (42, 40.8%), Mitral Valve Annuloplasty (MVA) + TVA (38, 36.9%), MVA (21, 20.4%), and MVR (2, 1.9%),respectively. Intraoperative hypoxemia, radiographic pulmonary infiltrates, and pneumonia were observed in 19 (18.4%), 84 (81.6%), and 13 (12.6%) patients, respectively. The LOS of ICU and POD were as follows: MVR + TVA (55.1 ± 25h, 9.9 ± 3.5 d), MVA + TVA (56.5 ± 28.4h, 9.4 ± 4.2d), MVA (37.9 ± 21.9h, 8.1 ± 2.3d) and MVR (48 ± 4.2h, 7.5 ± 2.1d). No reintubation, reoperations, postoperative cognitive dysfunction, 30-day mortality were observed in the present study. The present study demonstrated that applying this anesthesia management for TTCS associated with acceptable morbidity, intensive care unit and postoperative hospital lengths of stay. The finding from the present study might provide some new approach for Anesthesia management of TTCS.
全胸腔镜心脏手术(TTCS)的麻醉管理一直是诸多争论和讨论的主题。在这项单中心回顾性研究中,我们通过回顾本医疗中心的病历总结了TTCS临床麻醉管理的经验,并展望其未来发展。在这项回顾性研究中,纳入了103例患者(男性49例,女性54例),平均年龄为56.7±14.4岁。参与者分别接受二尖瓣置换术(MVR)+三尖瓣环成形术(TVA)(42例,40.8%)、二尖瓣环成形术(MVA)+TVA(38例,36.9%)、MVA(21例,20.4%)和MVR(2例,1.9%)。分别有19例(18.4%)、84例(81.6%)和13例(12.6%)患者术中出现低氧血症、影像学上的肺部浸润和肺炎。ICU住院时间和术后住院天数如下:MVR+TVA(55.1±25小时,9.9±3.5天)、MVA+TVA(56.5±28.4小时,9.4±4.2天)、MVA(37.9±21.9小时,8.1±2.3天)和MVR(48±4.2小时,7.5±2.1天)。本研究中未观察到再次插管、再次手术、术后认知功能障碍和30天死亡率。本研究表明,将这种麻醉管理应用于TTCS时,其发病率、重症监护病房住院时间和术后住院时间均可接受。本研究的结果可能为TTCS的麻醉管理提供一些新方法。