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微创瓣膜手术包括同期联合手术患者:一项回顾性研究。

Minimally invasive valve surgery including patients of combined simultaneous surgery: a retrospective study.

机构信息

Department of Cardiovascular Surgery, Shanghai East Hospital affiliated to Tongji University School of Medicine, 150 Jimo Rd, Shanghai, 200000, China.

Department of Anesthesiology, Hainan Hospital of Chinese PLA General Hospital, 80 Jianglin Rd, Sanya, 572013, China.

出版信息

J Cardiothorac Surg. 2023 Sep 30;18(1):266. doi: 10.1186/s13019-023-02361-8.

Abstract

OBJECTIVE

This study investigated the perioperative safety and advantages of performing a minimally invasive valve surgery (MIVS) and conducting a preliminary examination of the combined simultaneous surgery (CSS).

METHODS

A total of 29 patients (16 men and 13 women; mean age, 58.41 ± 13.08 years) who underwent MIVS at our center from July 2021 to March 2022 were selected. Among them, 16 patients underwent aortic valve surgery (AVS), 13 patients underwent mitral valve surgery (MVS), and four patients additionally underwent CSS.

RESULTS

The MIVS time ranged from 165 to 420 min, with a mean of 230.54 ± 54.61 min; the cardiopulmonary bypass (CPB) time ranged from 54 to 164 min, with a mean of 120.24 ± 25.98 min; the aortic cross-clamp (ACC) time ranged from 36 to 118 min, with a mean of 78.66 ± 21.01 min and an automatic heart resuscitating rate was 89.66%; the mean tracheal intubation time was 6.30 ± 3.87 h, and the median total postoperative drainage was 317.5 (35, 1470) ml. No difference was observed between preoperative and postoperative left ventricular ejection fraction (LVEF) (61.90% ± 6.28% vs. 60.21% ± 5.52%, P = 0.281). The difference in postoperative drainage (419.20 ml ± 377.20 ml vs. 588.75 ml ± 673.63 ml, P = .461), tracheal intubation time (6.66 h ± 4.27 h vs. 4.63 h ± 1.11 h, P = .359), intensive care unit (ICU) stay (3.96 ± 8.62 days vs. 2.00 ± 0.816 days, P = .658), and postoperative hospital stay (9.96 ± 8.45 days vs. 8.25 ± 1.26 days, P = .694) between MIVS and CSS was not significant.

CONCLUSION

MIVS in our center may be safe and effective. Additionally, CSS may be a feasible option that could be performed after a thorough preoperative evaluation and multidisciplinary discussion.

摘要

目的

本研究旨在探讨微创瓣膜手术(MIVS)的围手术期安全性和优势,并初步探讨同期联合手术(CSS)的应用。

方法

选择 2021 年 7 月至 2022 年 3 月在我院行 MIVS 的 29 例患者(男 16 例,女 13 例;平均年龄 58.41±13.08 岁)。其中,行主动脉瓣手术(AVS)16 例,二尖瓣手术(MVS)13 例,同期联合手术(CSS)4 例。

结果

MIVS 时间为 165~420 min,平均 230.54±54.61 min;体外循环(CPB)时间为 54~164 min,平均 120.24±25.98 min;主动脉阻断(ACC)时间为 36~118 min,平均 78.66±21.01 min,自动心脏复跳率为 89.66%;气管插管时间平均 6.30±3.87 h,总术后引流中位数为 317.5(35,1470)ml。术后左心室射血分数(LVEF)与术前相比无差异(61.90%±6.28% vs. 60.21%±5.52%,P=0.281)。术后引流(419.20 ml±377.20 ml vs. 588.75 ml±673.63 ml,P=0.461)、气管插管时间(6.66 h±4.27 h vs. 4.63 h±1.11 h,P=0.359)、重症监护病房(ICU)入住时间(3.96±8.62 天 vs. 2.00±0.816 天,P=0.658)和术后住院时间(9.96±8.45 天 vs. 8.25±1.26 天,P=0.694)在 MIVS 和 CSS 之间无显著差异。

结论

本中心的 MIVS 可能是安全有效的。此外,在充分的术前评估和多学科讨论后,CSS 可能是一种可行的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/451d/10541706/3e74ff634be8/13019_2023_2361_Fig1_HTML.jpg

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