电视胸腔镜下心脏不停跳心内直视手术

Video-assisted cardiac surgery with beating heart

目的总结胸腔镜辅助心脏不停跳下完成心内畸形矫治的治疗经验,探讨其在心血管外科应用的可行性。方法5例均采用单肺通气,经股动脉和股静脉建立周围体外循环。胸壁打孔,在胸腔镜的辅助下,心脏不停跳完成房间隔缺损(ASD)或室间隔缺损(VSD)修补术。结果术后过程顺利,随访6～14个月,全部心功能NYHAⅠ级,2例成人能参加重体力劳动。结论胸腔镜辅助心脏不停跳下完成房间隔和室间隔缺损修补手术具有不开胸骨的微创伤美观切口、术后疼痛轻、康复快和安全可靠的优点,可用于多种心脏病的外科治疗。

Objective To summarize the experience and access the feasibility, effective of video-assisted cardiac surgery with beating heart. Method Five patients who suffered from ASD or VSD were accepted in this group. An arterial catheter and venous catheter were placed in the right femoral artery and femoral vein to set up extracorporeal circulation. Two patients were performed through three lateral-right chest wall holes(1-2 cm) under thoracoscopy. The other three patients through a right anterior minithoracotomy and guided by video-assisted thoracoscopy with beating heart. Results The durations of extracorporeal circulation was 36-93(62 on average)mins. Postoperative course was uneventful. These five patients were followed-up from 6-14 months. There was no early or late death. NYHA function was normal. Conclusion Video-assisted cardiac surgery with beating heart is technically feasible and safe, that appears to be less traumatic, quick functional recuperation, excellent cosmetic healing, and shortening hospital stays. It can be used for the repair of congenital heart defects in general.