微创心脏外科发展现状及思考

Progress of minimally invasive cardiac surgery

心脏外科正在经历微创化的快速转变阶段。几十年来传统的体外循环下全胸骨切开心脏手术正受到各种新兴微创手术技术的冲击和挑战。目前心脏外科的各个亚专科,包括冠脉外科、瓣膜外科、先心病外科、大血管外科、心律失常外科等都有多种可供选择的微创手术技术。某些技术,如小切口瓣膜置换/成形,先心外科手术/封堵等应用已经相当普及。心脏外科医生应积极适应心脏外科的微创化趋势,但同时要保持冷静思辨的头脑,正确理解"微创"的内在涵义,严格掌握适应证,选择合适的患者及适宜的微创手术方式,实现最理想的治疗效果。

Summary Cardiovascular surgery is experiencing a rapid transformation towards minimally invasive.Conventional sternotomy incision with decades of history is being challenging and replacing by various emerging minimally invasive techniques.So far,all most all subspecialties of cardiovascular surgery,such as coronary diseases,valvular diseases,congenital heart diseases,great artery diseases,and arrhythmia diseases,have their own minimally invasive operations or surgical techniques.Some techniques,such as minimally invasive valve replacement valvuloplasty and surgical closure of congenital heart diseases are quite popular now.Cardiovascular surgeons should adapt to this minimally invasive trend.However,we should also keep our calm and critical mind at the same time.With correctly understanding of the meaning of ＂ minimally invasive＂,cardiovascular surgeons should strictly obey the indications,and select appropriate patients as well as feasible minimally invasive procedures in clinical practice.By doing these,the optimal therapeutic outcomes could be achieved finally.