微创肋间切口在心室辅助装置植入中的应用效果  

Clinical analysis of left ventricular assist device via minimally invasive thoracotomy

作　　者：郭锋伟[1] 郝军军[1] 李静[1] 宋艳[2] 李勇新[1] 闫炀[1] Guo Fengwei;Hao Junjun;Li Jing;Song Yan;Li Yongxin;Yan Yang(Department of Cardiovascular Surgery,The First Afiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China;Department of Ultrasound,The First Afiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,China)

机构地区：[1]西安交通大学第一附属医院心血管外科,西安710061 [2]西安交通大学第一附属医院超声医学科,西安710061

出　　处：《中华胸心血管外科杂志》2024年第5期257-261,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨微创肋间切口在左心室辅助装置(LVAD)植入术中的应用效果。方法回顾性收集2022年4月至2023年10月期间西安交通大学第一附属医院心血管外科经微创肋间切口完成的16例LVAD植入患者的临床资料。其中男10例,女6例;年龄49~76岁,平均(58.6±7.6)岁;体表面积1.35~2.01 m^(2),平均(1.75±0.90)m^(2)。疾病类型包括扩张型心肌病6例、缺血性心肌病8例、终末期心脏瓣膜病2例。血泵种类包括CH-VAD 8例,HeartCon 7例,Corheart-61例。16例患者均在体外循环下完成手术,其中13例采用心脏不停搏方式,3例采用心脏停搏方式。出血管位置在升主动脉15例,降主动脉1例。结果16例患者手术历时约5.09 h,体外循环(137±32)min,机械通气(20.8±13.6)h,ICU停留(10.0±6.3)天,住院(45.4±17.0)天。无中转开胸,无右心衰,无30天内死亡。结论微创肋间切口完成LVAD植入安全、可靠,可作为LVAD植入术的一种选择。Objective To evaluate the effectiveness of left ventricular assist device(LVAD)implantation via minimally invasive thoracotomy.Methods From April 2022 to October 2023,we retrospectively collected and analyzed the perioperative data of 16 patients underwent LVAD via minimally invasive thoracotomy in our institute.16 patients included 10 males and 6 females,the mean age was(58.6±7.6)(49-76)years old,BSA was(1.75±0.90)(1.35-2.01)m^(2),6 cases of dilated cardiomyopathy(DCM),8 cases of ischemic cardiomyopathy(ICM)and 2 cases of end-stage valvular heart disease.LVAD type included 8 cases of CH-VAD,7 cases of HeartCon and 1 case of Corheart-6.All the 16 patients underwent LVAD implantation were performed in condition of CPB,13 patients on-beating heart,3 patients with heart arrest.The outflow graft of 15 patients were place at ascending aorta,1 patient was descending aorta.Results The average surgical time was about 5.09 h,CPB time was(137±32)min,and the mechanical ventilation time was(20.8±13.6)h,stay in the ICU was(10.0±6.3)days,and the length of stay was(45.4±17.0)days.No case transition to sternotomy,no case in right ventricular failure,and no death case during 30 days.Conclusion Minimally invasive thoracotomy approach is a safe and reliable method for left ventricular assist devices implantation,and can be used as a choice for LVAD implantation.

关 键 词：微创 左心室辅助装置 临床效果 

分 类 号：R654.2[医药卫生—外科学]