左心瓣膜替换术后经右胸前外侧切口心脏不停跳下行三尖瓣替换术  

Tricuspid valve replacement with right anteriorlateral incision and heart beating after left cardiac valve replacement

作　　者：庞广辉[1] 张秀辉[1] 来永强[2,3] 马洪亮[1] 王庆欣[1] 张玉春[1] 李勇[1] 

机构地区：[1]临沂市人民医院心脏外科,山东临沂276003 [2]首都医科大学附属北京安贞医院心外科 [3]北京市心肺血管疾病研究所

出　　处：《临床心血管病杂志》2014年第8期731-733,共3页Journal of Clinical Cardiology

摘　　要：左心瓣膜替换术后远期三尖瓣关闭不全发病率为8%～30%,其中部分患者需要再次手术治疗[1]。再次胸部正中切口是最为常见的手术入路,但这种术式存在较多风险,如心脏及血管的损伤、心包粘连、胸骨愈合差、手术止血困难等。研究表明,再次正中切口被证明是再次手术中最危险的操作之一,其并发症的30%～40%与再次正中切口有关。我们采用右胸前外侧切口体外循环常温心脏不停跳、主动脉不阻断下经右心房切口行三尖瓣替换术，现报道如下。To explore the results of tricuspid valve replacement with right anteriorlateral thoracotomy and heart beating after left cardiac valve replacement. Retrospectively twelve patients with severe tricuspid insufficien- cy after left cardiac valve replacement underwent tricuspid valve replacement under right anteriorlateral thoracoto- my incision and heart beating . This procedure proves a safe and effective one for tricuspid valve replacement after left cardiac valve replacement. It avoids the disadvantages of redo-sternotomy, and decreases the occurrence of Ⅲ atrioventricular block after tricuspid valve replacement.

关 键 词：左心瓣膜替换术 右胸前外侧切口 体外循环 心脏不停跳 三尖瓣替换术 

分 类 号：R654.2[医药卫生—外科学]