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微创主动脉根部手术(Mini-Bentall):病例系列研究

Minimally Invasive Aortic Root Surgery (Mini-Bentall): Case Series Study.

作者信息

Avdagic Harun, Tabakovic Mustafa, Antonic Miha, Krdzalic Alisa, Sijercic Selma, Piric Melika, Sahinovic Maida

机构信息

Clinic of Cardiovascular Surgery, University Clinical Centre Tuzla, Bosnia and Herzegovina.

Department of Cardiac Surgery, University Clinical Centre Maribor, Slovenia.

出版信息

Med Arch. 2025;79(3):233-236. doi: 10.5455/medarh.2025.79.233-236.

Abstract

BACKGROUND

The upper mini sternotomy Bentall (mini-Bentall) procedure may result in less trauma and earlier recovery compared with the usual full sternotomy Bentall procedure (Usual Bentall-DeBono procedure).

OBJECTIVE

This study evaluates the efficacy and safety of mini sternotomy aortic root surgery (MSARS), a minimally invasive technique designed to reduce surgical trauma, improve postoperative recovery, and lower healthcare costs.

METHODS

The upper mini sternotomy (UMS) approach was performed in ten patients focusing on standardized surgical procedures, and rigorous postoperative care. Key findings indicate that MSARS markedly reduces postoperative complications, ICU stay, and overall hospital stay compared to traditional sternotomy.

RESULTS

The median postoperative length of stay was seven days for MSARS versus 11 days for traditional sternotomy, with ICU stays of 27 hours and 105 hours, respectively. Our study also highlights the cost-effectiveness of MSARS, with decreased hospital costs per patient due to reduced ICU resource utilization and shorter hospital stays. These findings suggest that MSARS is a valuable and advantageous alternative to traditional sternotomy, offering substantial benefits in terms of patient outcomes and healthcare efficiency.

CONCLUSION

Mini sternotomy aortic root surgery via partial upper sternotomy could be a safe alternative to the full median sternotomy, marking a significant advancement in the field of cardiac surgery.

摘要

背景

与常规全胸骨切开 Bentall 手术(常规 Bentall-DeBono 手术)相比,上半部分胸骨切开 Bentall 手术(mini-Bentall)可能造成的创伤更小,恢复更快。

目的

本研究评估上半部分胸骨切开主动脉根部手术(MSARS)的有效性和安全性,这是一种旨在减少手术创伤、改善术后恢复并降低医疗成本的微创技术。

方法

对 10 例患者实施上半部分胸骨切开(UMS)手术,重点关注标准化手术流程和严格的术后护理。关键发现表明,与传统胸骨切开术相比,MSARS 显著降低了术后并发症、重症监护病房(ICU)住院时间和总体住院时间。

结果

MSARS 术后中位住院时间为 7 天,而传统胸骨切开术为 11 天,ICU 住院时间分别为 27 小时和 105 小时。我们的研究还强调了 MSARS 的成本效益,由于减少了 ICU 资源利用和缩短了住院时间,每位患者的住院费用降低。这些发现表明,MSARS 是传统胸骨切开术的一种有价值且具有优势的替代方法,在患者预后和医疗效率方面具有显著益处。

结论

通过部分上半部分胸骨切开进行的上半部分胸骨切开主动脉根部手术可能是全胸骨正中切开术的一种安全替代方法,标志着心脏外科领域的一项重大进展。

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本文引用的文献

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Midterm Results of a Minimally Invasive Approach in David Procedure.大卫手术微创入路的中期结果
Thorac Cardiovasc Surg. 2018 Jun;66(4):301-306. doi: 10.1055/s-0037-1603495. Epub 2017 Jun 5.
9
Ministernotomy approach for surgery of the aortic root and ascending aorta.主动脉根部和升主动脉手术的微创胸骨切开术入路。
Interact Cardiovasc Thorac Surg. 2009 Nov;9(5):849-58. doi: 10.1510/icvts.2009.206904. Epub 2009 Aug 7.
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Minimally invasive approach for complex cardiac surgery procedures.复杂心脏手术的微创方法。
Ann Thorac Surg. 2009 Aug;88(2):462-6; discussion 467. doi: 10.1016/j.athoracsur.2009.04.060.

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