不同手术切口再次房室瓣置换的临床对比评价

CLINICAL COMPARATIVE EVALUATION OF RE-DO ATRIO-VENTRICULAR VALVE REPLACEMENT VIA A RIGHT ANTEROLATERAL THORACOTOMY VERSUS REPEATED MEDIAN STERNOTOMY

回顾分析自１９８４年底至１９９４年５月间用不同手术切口行再次房室瓣置换３０例；１５例经由右前外侧切口，１５例经由再次胸骨正中切口。对比观察发现，右前外侧切口能快速建立体外循环，明显地缩短手术时间，术后引流量较少且心包填塞发生率较再次胸骨正中切口为低。作者认为再次房室瓣置换，右前外侧切口较再次胸骨正中切口为优。

rom the end of 1984 to May 1994,30 cases of re-replacement of atrio-ventricularvalves via a right anterolateral thoracotomy or repeated median sternotomy were analysedretrospectively. 15 cases were operated via right anterolateral thoracotomy,another 15 werethrough repeated median sternotomy.The comparative observations showed that the car-diopulmonary bypass could be established faster,with shorter operative time,less postopera-tive bleeding and fewer cardiac tamponade via right anterolateral thoracotomy than via a re-peated median sternotomy. The authors believed that the right anterolateral thoracotomy was much more suitablefor re-do replacement of atrio-ventricular valves than a second median sternotomy.