ObjectiveTo summarize the clinical experience of aortic valve replacement surgery with minimally invasive procedure. MethodsWe retrospectively analyzed the clinical data of 72 patients underwent isolated aortic valve replacement in our hospital between January 2011 and August 2013. The patients undergoing minimally invasive procedure were as a minimally invasive group(30 patients with 18 males and 12 females at age of 60.2±13.4 years). The patients undergoings conventional procedure were as a control group(42 patients with 27 males and 15 females at age of 61.3±14.5 years). The outcomes of the two groups were compared. ResultsThere was no death and severe complication in both groups. Postoperative echocardiography showed no paravalvular leakage, no valve dysfunction in both groups. There were no significant statistically differences between the two groups in cardiopulmonary bypass time, aortic crossclamping time, ventilation time, postoperative left ventricle ejection fraction, the length of ICU stay and hospital stay (P>0.05). Blood transfusion ratio, blood transfusion volume and blood loss volume were lower in the minimally invasive group than those in the control group (P<0.05). The length of incision, chest closure time, operative duration were shorter in the minimally invasive group than those in the control group (P<0.05). ConclusionUpper median sternotomy is a safe and feasible procedure for minimally invasive aortic valve replacement surgery. Compared with conventional aortic valve replacement, its advantages include less surgical trauma, stable sternum, rapid recovery, less blood loss and blood transfusion, and cosmetic outcomes.
目的 探討胸部正中小切口在嬰幼兒先天性心臟病手術治療中的可行性及效果。 方法 將我院 2016 年 5 月至 2016 年 10 月 170 例行手術治療的常見先天性心臟病嬰幼兒患者分為兩組：常規組，85 例，男42例、女43例，年齡（6.9±2.1）個月，采用常規胸部正中切口；小切口組，85 例采用胸部正中小切口，男43例、女42例，年齡（6.4±1.8）個月。小切口手術切口于平第 3 肋間切開，止于劍突起始處上 0.5 cm，剛好放入小胸骨撐開器為好。 結果 兩組患兒體外循環時間差異無統計學意義（P>0.05）。小切口組手術時間略長（P<0.05）。兩組預后沒有差別，但是小切口組傷口長度顯著縮短[（7.8±0.8） cmvs. （4.0±0.5）cm，P<0.05]。 結論 正中小切口基本具有胸骨正中切口的優點，可顯露心臟各部位，滿足絕大部分心臟探查和手術操作需要，必要時仍可向上延長切口使心內操作不受限制等優點，故認為正中小切口在嬰幼兒心臟手術中具有良好的安全性和美觀性。