微创心脏不停跳或低温停跳心内直视手术

Minimally invasive open-heart operation adopting stop or on heart beating

目的 报告 89例采用微创手术方式进行心脏直视外科治疗的病例。方法 体外循环下心脏不停跳经右腋下 6cm～ 8cm弧形小切口行心内直视手术 41例 ,中低温停跳心内手术 48例。结果 全组心肺转流插管顺利 ,心内显露满意 ,手术经过顺利 ,病人均痊愈出院。结论 经右腋下切口不需劈开胸骨、切除肋骨 ,创伤小 ;心脏不停跳 ,不需要降温 ,不存在再灌注损伤 ;皮肤切口隐于腋下 ,美学效果佳 ;术后感染机率低 ,恢复快 ,住院时间短。需要经过升主动脉、右心房、右心室及左心房的心内直视手术无明显禁忌症。胸壁进路以第三。

Objective To review the experience of minimally invasive cardiac surgery(MICS) and report 89 cases performed open heart operation adopting no stop or stop beating.Methods 41 cases underwent open heart operation under cardiopulmonary bypass(CPB) with heart beating through a right oxter small incision,and 48 cases under CPB with low temperature and stop heart beating.Results The spiling and CPB of whole were in kilter.The exposure within heart was satsfactory.The procedure of the operation went smoothly.Conclusion The small incision of MICS doesn't need cleaving sternum and ribs or bringing down temperature and warning up and doesn't have re perfusion damage in no stop beating group.The aesthetic effect is very good.With quick recuperation and low infection rate after operation the hospitalization perios is shortened greatly.The open heart operation doesn't have contraindications through the pathway of ascending aorta and right atrium,and through right ventricle and left atrium.