微创右胸小切口修补房间隔缺损(附31例报告)

Right Minithoracotomy for Repair of Atrial Septal Defect

报告自1997年5月至1998年11月期间采用微创右胸小切口修补房间隔缺损31例的结果。原发孔房间隔缺损合并二尖瓣大瓣裂缺1例,继发孔房间隔缺损30例,其中,中央型缺损25例,上腔型缺损1例,下腔型缺损2例,合并室间隔缺损2例,合并右肺静脉异位引流2例。手术通过右胸第四肋间小切口(7～10cm)在体外循环下完成,全组无手术死亡和并发症,病人恢复快。结论:右胸小切口修补房间隔缺损是可行的。

31 patients with atrial septal defect (10 male and 21 female) were operated by minimal invasive procedure, between May 1997 and November 1998. There were 26 patients with secundum atrial defect, 2 with secundum and VSD, 2 with secundum and right unilateral anomallous pulmonary venous connection, and 1 with ostium primum. Their age aranged from 3 to 56 years (mean 28 years). The operations were performed through a right anterolateral or lateral minithorocotomy (7cm - 10cm). The chest was entered in the fourth intercotal space. Cannulation through aorta,SVC and IVC was made, and standard cardiopulmonary bypass with moderate hypothermia, aortic cross-clamping and cardioplegia was used in all patients. All defects were repaired through right atrium and right ventriculus. Results :There was no mortality, no residual shunt, and no wound infection. Conclusion:The right minithoracotomy incision appears to be safe and effective as standard sternotomy method for repair of atrial septal defect. The limited incision can provide less blood loss, early extubation, short-stay in hospital, and more cosmetic.