右腋下小切口行心内直视手术26例

Right Subaxillary Minithoractomy for Open Heart Surgery: A Report of 26 Cases

目的:总结右腋下小切口行心内直视手术治疗体会。方法:回顾分析了26例经右腋下小切口行心内直视手术的临床资料,切口取右腋中线与第3肋的交点为上缘,腋中线与第6肋的交点为下缘,经第4或第3肋间入胸,其中房间隔缺损15例、室间隔缺损10例、二尖瓣置换+右肺中叶切除1例。结果:全组26例手术顺利,无严重并发症;其中二尖瓣置换+右肺中叶切除的患者,并同行三尖瓣DeVega环缩,术后出现高热,抗炎治疗1月后治愈。结论:经右腋下小切口径路行心内直视手术,是一种安全、有效、美观的手术方式,具有损伤小,瘢痕隐蔽,不破坏胸廓完整性,出血少,恢复快等优点,符合微创外科的原则。

Objective To summarize experience of open heart surgery through right subaxillary minithoractomy. Methods Clinical data of 26 patients were retrospectively analyzed, including 15 with atrial septal defect, 10 with ventricular septal defect and one with mitral value replacement and the middle of the right lung resection. The intersection was at the fight midaxillary line and the third rib as the upper margin of incision, and that of the midaxillary line and the sixth rib as the lower margin, going through the third or the fourth intercostal space. Results All of the 26 patients were operated successfully without serious complications. The patient with mitral value replacement combined tricuspid valve DeVega operation, emerging high fever, and being cured after anti-inflammatory treatment for one month. Conclusion Open heart surgery through right subaxillary minithoractomy is a safe, effective, aesthetic surgery, with the advantages of small injury, hidden scars, maintaining the integrity of thorax, less bleeding, rapid recovery, etc., being consistent with the principle of minimally invasive surgery.