电视胸腔镜辅助下微创二尖瓣手术42例  

Minimally invasive mitral valve surgery in 42 cases by video-assisted thoracoscopic surgery

作　　者：吴永兵[1] 周建良[1] 张小强[1] 杨崛圣[1] 董啸[1] 唐燕华[1] 徐建军[1] 

机构地区：[1]南昌大学第二附属医院胸外科,南昌330006

出　　处：《江西医药》2012年第4期289-290,307,共3页Jiangxi Medical Journal

摘　　要：目的总结电视胸腔镜辅助下右胸小切口微创二尖瓣手术的经验。方法右股动、静脉和(或)上腔静脉插管建立体外循环;右胸壁小切口+四孔(胸腔镜孔、Chitwood阻断钳入孔、左心引流管孔、心房拉钩孔),Chitwood阻断钳阻闭升主动脉,冷血心脏停搏液顺行灌注保护心肌,电视胸腔镜辅助下行二尖瓣置换32例,二尖瓣成形4例,二尖瓣置换+三尖瓣成形6例。结果全组无中转胸骨正中开胸、无再次开胸止血,无死亡病例。结论电视胸腔镜辅助下右胸小切口行二尖瓣手术安全可靠,创伤小,恢复快,美容效果好,患者满意度高,值得临床推广应用。Objective To summarize the experience of the right chest minimally invasive mitral valve surgery under video-assisted thoracoscopic surgery. Methods Applying right femoral arterial catheterization for blood supply, fight femoral vena And （or） superior vena catheterization as blood drainage to establish peripheral extraeorporeal circulation.Small incision of the right chest wall plus four-hole （for video-assisted thoracoscope, Chitwood occlusion clamp,left ventricular drainage, atrial retractor）, Chitwood blocking clamp blocked ascending aorta,myocardium was protected by cold blood cardioplegia antegrade perfusion,and Mitral valve replacement （MVR） in 32 cases,mitral valvuloplasty in 4, MVR plus tricuspid valvoplasty （TVP） in 6 were performed by video-assisted thoraeoscopic surgery. Results There were no interim sternal thoracotomy, no re-thoracotomy to stop bleeding, and no deaths. Conclusion The fight chest minimally invasive mitral valve surgery under video-assisted thoracoseopic surgery has the advantage of safety and reliability, less trauma,quicker recovery,better cosmetic results,high satisfaction of patient. It is worthy of clinical application.

关 键 词：电视胸腔镜 微创小切口 右胸前外侧切口 二尖瓣手术 

分 类 号：R654.2[医药卫生—外科学]