“Y”型或“I”型部分胸骨切口行心内直视手术30例

Report of open heart surgery through Y or I-shape partial median sternotomy: 30 cases

目的介绍经"Ｙ"型或"Ｉ"型部分胸骨切口行心内直视手术的体会。方法取下１／２～２／３胸部正中皮肤切口，纵行劈下２／３胸骨使呈"Ｙ"型或"Ｉ"型，体外循环直视下行心内直视手术３０例，其中二尖瓣置换９例，二尖瓣成形２例，法乐四联症矫治１１例，室间隔缺损修补８例。结果全部病例无手术死亡及并发症。疤痕长度仅为胸骨正中切口的６０％左右。结论"Ｙ"型或"Ｉ"型部分胸骨切口可安全有效地完成大部分心脏疾病的手术，创伤的程度及术后美容效果明显优于胸骨正中切口，手术适应症的范围明显大于右胸小切口。

Objective To introduce the experience in open heart surgery through Y-or I-shape partial median sternotomy. MethodsOpen heart surgery with extracorporeal circulation were made through lower 1/2-2/3 median thoracotomy incisions andlongitudinally splitting the sternum as a Y-or I-shape on its lower 2/3 in 30 patients, of them, 9 received mitral valve replacement. 2mitral valvuloplasly. 11 tetralogy of Fallot repair and & ventricular septal defects closure. Results There was no operative mortality inthis group. The length of incision scar was only about 60% of median sternotomy incision. Conclusion The Y- or I-shape partialmedian sternotomy incision was sate and effective in most of open heart surgeries, Which is superior to the median sternotomyincision in seventy of operative wound and comestic effect its operative indication is in a broader scope than that of small rightthoracotomy incision.