在先前的心脏手术后进行内镜 mitra和三膜手术
Filip P Casselman1, Mark La Meir, Hughes Jeanmart
1Department of Cardiovascular and Thoracic Surgery, OLV Clinic, Moorselbaan 164, 9300 AALST, Belgium. filip.casselman@olvz-aalst.be
Circulation
|September 14, 2007
概括
这项研究表明,在重复手术心脏手术中,正确的视频辅助方法对心房膜疾病是可行的和有效的. 患者的死亡率低于预期,对这种微创技术的满意度高.
科学领域:
- 心血管外科心血管外科
- 最少侵入性的技术
- 心脏门的修复和更换
背景情况:
- 对心房膜疾病的再手术心脏手术带来了独特的挑战.
- 以前的心脏手术可能会导致粘附,并使手术访问复杂化.
研究的目的:
- 评价前经过心脏手术的患者心房膜疾病的正确视频辅助方法的可行性和有效性.
- 评估结果,包括死亡率,发病率和患者满意度.
主要方法:
- 对80名接受再手术心房门手术的成年患者的回顾性分析 (1997年12月 - 2006年5月).
- 使用了右视频辅助方法,没有肋骨扩张,采用大腿管道和内耳门紧.
- 程序包括 mitra 门的修复/更换和三门的更换.
主要成果:
- 操作死亡率为3.8%,明显低于预测 (O/E 0.24).
- 术后发病率包括2.5%的中风率;平均住院时间为10.7天.
- 一年和四年生存率分别为93.6%和85.6%,患者更喜欢微创方法.
结论:
- 视频辅助的最小接入手术是先前心脏手术后心房门疾病的可行和有效选择.
- 与传统方法相比,这种方法可以降低死亡率并提高患者满意度.
- 在当前的外科实践中,建议增加这种技术的使用.
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