经肋间小切口主动脉根部置换手术临床经验

Clinical experience of Bentall surgery via small intercostal incis

目的总结本科行经肋间小切口主动脉根部置换(Bentall)手术的临床经验,探讨经肋间小切口Bentall手术的安全性及可靠性。方法回顾性分析2021年1月至2023年2月在本科行经肋间小切口Bentall术的4例患者临床资料。术前诊断为主动脉根部瘤+主动脉瓣重度关闭不全4例,其中升主动脉扩张1例。全部行经右侧胸骨旁第3肋间切口Bentall术+主动脉根部分流术。结果4例患者均顺利完成手术,无中转正中开胸,无二次开胸探查止血,术后无严重并发症发生,无死亡,均康复出院。结论经肋间小切口主动脉手术在技术上是安全可靠的,其手术区域创伤小,术后恢复快,治疗效果确切。

Objective To summarize the clinical experience of the transcostal mini-incision Bentall surgery in our department and to discuss the safety and reliability of the transcostal mini-incision Bentall surgery.Methods We retrospectively analyzed the clinical data of 4 patients who underwent Bentall's operation via small intercostal incision in our department from January 2021 to February 2023.Preoperative diagnosis of aortic root aneurysm and severe aortic valve insufficiency was made in 4 cases,including 1 case of ascending aortic dilatation.All of them underwent aortic root replacement(Bentall's procedure)and aortic root bypass via the right parasternal 3rd intercostal incision.Results All four patients completed the surgery successfully,with no median sternotomy,no secondary open-chest exploration for hemostasis,no serious postoperative complications,no death,and all patients recovered and discharged from the hospital.Conclusion Transcostal mini-small incision aortic surgery is technically safe and reliable with minimal trauma to the surgical region,rapid postoperative recovery,and definite therapeutic effects.