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内镜动脉置换:孤立和并发手术的初始结果

Soh Hosoba¹, Toshiaki Ito¹, Makoto Mori²

¹Department of Cardiovascular Surgery, Japanese Red Cross Aichi Medical Center Nagoya Daiichi Hospital, Nagoya, Japan.

The Annals of thoracic surgery

|June 5, 2023

概括

完全内镜外科动脉置换 (AVR) 适用于多门手术. 这种最少的侵入性方法证明了单独的和同时进行的AVR手术的安全结果.

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:

在需要多个门手术的患者中,完全内镜外科大动脉置换 (AVR) 的可行性以前是未知的.
这项研究旨在描述完全内镜AVR的方法并评估外科手术后的结果,无论是单独的还是与其他门手术一起的.

研究的目的:

评估完全内镜性大动脉置换 (AVR) 的适用性和安全性,在接受隔离或同时进行门手术的患者中.
评估与这种微创手术技术相关的术后结果,包括死亡率和重大不良事件.

主要方法:

总共有216名患者在2017年5月至2022年10月期间使用3端口技术进行了完全内镜AVR.
程序涉及一个主端口,3D内镜端口和一个左手端口与大腿管; sutures手绑.
与并发手术和没有并发手术的患者之间的术后结果进行了比较.

主要成果:

在15.2%的患者中,同时进行了手术,其中最常见的是 mitra 门手术 (63.6%).
植入了各种门类型,其中支架式生物假体是最常见的 (76.3%).
该研究报告了低30天死亡率 (0.5%),低转换到胸腔切除率 (0.9%),以及较低的重大神经事件发病率 (1.4%),在孤立和并发AVR组中都有相似的不良事件率.

结论:

完全内镜AVR对于需要隔离或同时进行门手术的患者来说是一种安全有效的方法.
这种微侵袭的技术可以成功地应用于解决多膜疾病,提供与隔离AVR相比的安全性.

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