右胸前外侧小切口心脏跳动下矫治先天性心脏缺损

Open heart surgery with right anterolateral thoracotomy on beating heart during CPB

目的 评价右胸前外侧小切口心脏跳动下的心内直视矫治手术的应用价值。方法 1999年 11月～ 2 0 0 3年 1月采用右胸前外侧小切口路径 ,在心脏跳动下行 2 4例房间隔缺损修补术 ,部分型心内膜垫缺损矫正术 16例作为对照组。其中男 14例 ,女 2 6例 ,年龄 3～ 4 0岁。结果 手术顺利 ,所有患者随访 2～ 2 0月 ,均健在 ,无术后并发症。房间隔缺损修补术患者体外循环 (32 5 0± 18 5 0 )min ,术后呼吸机辅助呼吸 (2 0 0± 1 2 0 )h ;对照组患者体外循环 (6 8 5 0±17 5 0 )min ,术后呼吸机辅助呼吸 (4 2 0± 1 10 )h。结论 右胸前外侧小切口心脏跳动下矫治先天性心脏缺损的心内直视手术是可行、有效。

Objective To envaluate the value of open heart surgery with right anterolateral thoractomy on beating heart. Methods From November 1999 to January 2003, 40 patients with congenital heart malformations underwent open heart surgery using the technique of right anterolateral thoractomy on beating heart. Diagnosis included: atrial septal defect in 24 and incomplete endocardial cushion defect in 16 as control group. They were 14 males and 26 females. The age ranged from 3 years to 40 years. Results All patients were followed up from 2 months to 20 months. There was no operative or late mortality related to the thoracotomy approach, and no postoperative complications. The CPB time of the patients with atrial septal was (32 50±18 50) min,and the postoperative averge menchanical ventilation time was (2 00±1 20) h. The CPB time of the control group was (68 50±17 50) min,and the postoperative averge menchanical ventilation time was (4 20±1 10) h. Conclusion Open heart surgery with right anterolateral thoractomy on beating heart is a feasible,effective and safe technique for repairing congenital heart.