Santibáñez Escobar F, Serrano Gallardo G, Ramirez Marroquin S, Lopez Soriano F, Barragán García R
Department of Cardiac Surgery, Instituto Nacional de Cardiología Ignacio Chavez, Mexico City, Mexico.
Tex Heart Inst J. 1997;24(3):209-14.
We describe our experience with the transseptal approach for mitral valve replacement, a technique that we applied especially in cases of 3rd and 4th operations wherein numerous adhesions made the usual left atrial approach difficult. We report 39 cases of mitral procedures in which we used 3 slightly different transseptal approaches, depending on the cardiac anatomy and the preferences of the surgeon. There were no complications associated with any of these approaches. Indeed they made the mitral valve procedure easier, because they enabled full exposure of the mitral valvular and subvalvular apparatus. We also propose the transseptal approach as a very safe and reproducible technique for use in patients with friable tissues, heavily calcified mitral valves, or small left atria- and in patients who must undergo combined tricuspid and mitral procedures. In this series, there were no conduction abnormalities secondary to the approach, nor were there any procedure-related deaths.
我们描述了经房间隔入路进行二尖瓣置换术的经验，该技术尤其适用于第三次和第四次手术，因为在这些手术中，大量粘连使得常规的左心房入路变得困难。我们报告了39例二尖瓣手术病例，根据心脏解剖结构和外科医生的偏好，我们使用了3种略有不同的经房间隔入路。这些入路均未出现并发症。事实上，它们使二尖瓣手术变得更容易，因为它们能够充分暴露二尖瓣及其瓣膜下结构。我们还提出，对于组织脆弱、二尖瓣严重钙化、左心房较小的患者，以及必须同时进行三尖瓣和二尖瓣手术的患者，经房间隔入路是一种非常安全且可重复的技术。在本系列病例中，该入路未引发传导异常，也没有与手术相关的死亡病例。
