经胸小切口大型房间隔缺损封堵术的临床应用

Application of occlusion of large atrial septal defect via chest small incision

目的评价经胸小切口大型房间隔缺损封堵术的临床应用疗效。方法对15例继发孔大型房间隔缺损(直径>35mm)患者取右前胸第4肋间小切口,经右胸腔、心包、右心房入路行房间隔缺损封堵术,术中利用经食道超声(TEE)监测引导。结果15例患者均封堵成功,术中术后无并发症发生,手术时间45～120min,均未输血。患者术后第2天下床活动,术后5～8d出院。随访患者一般情况良好,心功能得到改善。结论经胸小切口大型房间隔缺损封堵术损伤小,操作安全简便,临床效果良好。

Objective To assess the clinical effect of occlusion of large atrial septal defects （ASDs） via chest small incision. Methods The large ASDs（〉35 mm in diameter） were occluded via right chest small incision of the 4^th intercostal space in 15 patients. The operation was instructed by transthoracic echocardiography （TEE）, Results The defects of 15 patients were all occluded successfully with a mean operation time of （81±32） minutes. No complications happened and no blood transfusion was needed. Out-of-bed activity was on the second day and mean hospital stay was （6. 3±0. 9） days. Conclusion Occlusion of large ASDs through chest small incision is safe, effective and easy to perform with a minimal invasion.