Arís A, Padró J M, Cámara M L
Servicio de Cirugía Cardíaca, Hospital de la Santa Creu i Sant Pau, Barcelona.
Rev Esp Cardiol. 1997 Nov;50(11):778-81. doi: 10.1016/s0300-8932(97)74680-3.
Minimally invasive surgery is being applied to certain procedures in cardiac surgery. Aortic valve replacement presents the highest number of cases in which this approach is feasible.
Fifteen patients, aged 16 to 75 years, underwent aortic valve replacement through a 10 cm incision at the level of the second intercostal space. Cardiopulmonary bypass was instituted through cannulation of the aorta and the femoral vein.
Adequate exposure of the aortic root was achieved in all cases. Valve replacement was accomplished with a mean ischemic time of 50 +/- 6 minutes and a pump time of 80 +/- 14 minutes. Mean chest drainage was of 310 +/- 251 ml. The patients were discharged between the third and the fifth day of the postoperative course.
A transverse incision at the level of the second intercostal space provides an excellent exposure for aortic valve replacement. Surgical times are not excessively prolonged and patient's recovery is faster and less painful than with the standard midline sternotomy.
微创手术正在应用于心脏外科的某些手术中。主动脉瓣置换术是这种方法可行的病例数最多的手术。
15例年龄在16至75岁之间的患者,通过在第二肋间水平做一个10厘米的切口进行主动脉瓣置换术。通过主动脉和股静脉插管建立体外循环。
所有病例均实现了对主动脉根部的充分暴露。瓣膜置换术的平均缺血时间为50±6分钟,体外循环时间为80±14分钟。平均胸腔引流量为310±251毫升。患者在术后病程的第三天至第五天出院。
第二肋间水平的横向切口为主动脉瓣置换术提供了良好的暴露。手术时间不会过度延长,与标准正中胸骨切开术相比,患者恢复更快且疼痛减轻。