微创心脏手术治疗先天性心脏病50例临床分析

Treatment of 50 Cases with Congenial Heart Disease by Minimal lnvasive Surgery

目的：探讨微创心脏手术（MICS）治疗先天性心脏病的临床疗效。方法：采用微创心脏手术中小切口和介入封堵术治疗先天性心脏病患者50例。21例VSD中20例在电透下行介入封堵术，1例封堵失败改行右腋下小切口体外循环下修补术；18例PDA全部行介入封堵术；10例ASD中，6例中央型行小切口直视下配合床边心超封堵术，4例非中央型或长径在30mm以上病例行右腋下小切口体外循环心脏不停跳下修补术；1例主动脉窦瘤在电透下行介入封堵术。结果：手术均顺利，全组无死亡。50例患者术后随访2—6个月，心脏听诊无杂音，心超复查无残余分流，心功能I级。疗效满意。结论：小切口和介入封堵术治疗先天性心脏病，具有切口小（或无切口）、出血少、住院短、美观、微创的优势，具有广阔的应用前景。

Objective：To explore the clinical efficacy of the minimally invasive cardiac surgery to treat the congenial heart disease. Methods：The clinical data of 50 patients who accepted the minimally invasive car diac surgery were retrospectively summarized. Among them, 20 in 21 VSD （ Ventricular Septal Defect） patients accepted the interference shutoff operation, 1 VSD patient underwent the repair operation under right oxter little incision. 18 PDA（ Patent duktus arteriosus） patients accepted the interference shutoff operation; 6 in 10 ASD （atrial septal defect） patients accepted the interference shutoff operation under the UCG （cardiac color ultra sonography） bedside with little incision. Those patients were central ASD. The rest ASD patients with ASD di ameter beyond 30mm accepted the repair operation via eardiopulmonary bypass without heartbeat halted under right oxter little incision. 1 aortic sinus hump patient accepted the operation of interference shutoff operation un der the fluoroscopy. Results：All patients were alive. 50 patients were followed up 2-6 months. All patients had no cardiac souffle and the remnants of detour. All heart functions were Grade I and the effect was satisfy ing. Conclusions ： Little incision and interference shutoff operation have the superiority of little incision （ or no incision） ,less bleeding,less time in hospital, minimally invasive surgery and good shape. Therefore, this oper ation formula has wide prospect.