左腋下小切口治疗成人动脉导管未闭30例

APPLICATION OF MINIMALLY INVASIVE TREATMENT FOR PATENT DUCTUS ARTERIOUSUS IN ADULTS:A REPORT OF 30 CASES

目的 探讨成人动脉导管未闭 (PDA)患者左腋下小切口治疗的安全术式及应用价值。方法 采用左腋下胸壁小切口 ,结扎线从胸降主动脉后方转移 ,对 30例成人 (2 0～ 35岁 )PDA患者进行手术治疗。结果 30例均获成功 ,术后第二天即可下床活动 ,术后杂音消失 ,无手术并发症 ,复查心脏彩超无残余分流 ,随访未见导管再通。结论 该术式具有损伤小、不破坏胸廓连续性、瘢痕隐蔽、安全性高、出血少、疼痛轻、恢复快等优点 ,符合外科微创原则 ,手术效果满意 ,适宜治疗成人PDA患者。

Objective To study the safe method of operation andvalue of minimally invasive in treatment of adult patients with patent ductus arteriosus. Methods 30 patients,aged from 20 to 35 years old,were operated successfully from February 1997 to February 2004:patent ductus arteriosus may be ligated via a small left lateral thoracic incision under the axilla with sutures were transfered from the back of descending thoracic aorta to the back of the ductus without dissecting the ductus. Results The operation on the 30 cases were all successful.Due to the minor surgical trauma, the patients were able to ambulate two days after the surgery.Heart murmur completely disappeared postoperatively.No complications occurred.Postoperative echocardiogram showed no residual or recurrent shunt,even in three or six months' follow-up. Conclusion Left mini-thoracotomy is minimally invasive,without impairing the integrity of the bony thorax.It gives excellent cosmetic results and prevents patients from severe pains.It might have wider indications for treatment of patent ductus arteriosus in adults.