右前外胸部小切口行心脏不停跳心内直视手术  

Open Heart Operation on Beating Heart Through Small Right Anteriolatteral Thoracic Incision

作　　者：陈林[1] 肖颖彬[1] 王学峰[1] 陈柏成[1] 陈进劲[1] 王咏[1] 周骐[1] 刘兵[1] 方骏[1] 

机构地区：[1]第三军医大学新桥医院心外科,重庆400037

出　　处：《重庆医学》1999年第6期403-404,共2页Chongqing medicine

摘　　要：目的介绍２７例右前外胸部小切口心脏不停跳体外循环心内直视手术的体会。方法：采用右前外胸部小切口 ２７例中，男１６例，女１１例，年龄１．８～４２岁，皮肤切口全长，儿童为８～１０ｃｍ，成人１０～１５ｃｍ，第四肋间入胸，在全麻浅低温心脏不停跳体外循环下进行，其中（ＡＳＤ）房缺 ３例，原发孔房缺（Ｐ－ＡＳＤ）１例，室缺（ＶＳＤ）１６例，室缺伴右室流出道狭窄（Ｖ９３＋ ＲＶＯＴ） １例， 二尖瓣置换２例，主动脉瓣置换术３例。结果：全组无空气栓塞和死亡，均痊愈出院。结论：右胸前小切口对传统经右心房切口的心内畸形，如房缺，膜周部空缺，以及经房间往路的二尖瓣置换术，即有创口小，又有美容的效果，但对复杂畸形不宜采用。Objective:The aim was to introduce the technique of open heart operation on beating heart through small right anteriolat eral thoracic incision. Methods:Twenty - seven patients underwent open heart operation on beating hearts under mid hypothermic cardiopul monary bypass through this incision, including 4 cases of ASD, 1 case of P- ASD, 16 cases of VSD, 1 case of VSD and RVOT, 3 cases of AVR, 2 cases of MVR. Results: There was no operative death and no incident of air embolism. Conclusion:The open heart operation on beating heart through small right anteriolateral thoracic incision is a safe and efffective alternation for simple cardiac defects. It is superior than median sterntomy for its tramatic and cosmetic reason.

关 键 词：心内直视手术 小切口 左胸部切口 心脏不停跳 

分 类 号：R654.2[医药卫生—外科学]