通过右侧小胸口切除术进行视频辅助的 mitra 膜再操作:一个单中心体验
Mehmet Ezelsoy1, Kerem Oral1, Ayten Saraçoğlu2
1Department of Cardiovascular Surgery, Koç University Faculty of Medicine, İstanbul, Türkiye.
Turkish journal of surgery
|May 15, 2025
概括
没有大动脉交叉紧的最小侵入性 mitra 门手术是以前进行心脏手术的患者的安全和有效选择. 这种技术利用视频辅助的右侧小胸切除术,显示出有希望的结果,并发症率低.
科学领域:
- 心血管外科心血管外科
- 最少侵入性心脏外科手术
背景情况:
- 之前的心脏手术,特别是胸切除,增加了复杂性和重复的米特拉门手术的风险.
- 传统的重复手术 mitra 门手术往往需要 resternotomy,与较高的发病率和死亡率相关.
研究的目的:
- 评估在没有主动脉交叉紧的情况下进行的微创性心肌膜外科手术技术的结果,在有先前心脏手术史的患者中进行.
- 评估视频辅助右小胸口切除术在重复手术中使用的安全性和有效性.
主要方法:
- 包括一系列连续的24名患者,这些患者在2015年1月至2018年12月期间接受了 mitra 门手术.
- 这项手术涉及视频辅助的右侧小胸切除术,股骨-股骨绕道术和26°C的心肺绕道术,无需动脉交叉紧.
- 根据个体患者的解剖学和病理学,进行了对心心膜的修复或更换.
主要成果:
- 50%的患者进行了米特拉置换,50%的患者进行了修复.
- 平均射出分数为46.08±6.52%,平均年龄为61.52±11.48岁.
- 术后并发症包括低心输出综合征 (4.1%),功能衰竭 (8.3%),肺炎 (8.3%),中风 (4.1%),以及因出血而重新手术 (8.3%). 平均住院时间为10.54天.
结论:
- 没有大动脉交叉紧的微创性 mitra 门手术是可行的和安全的方法,为选定的患者之前的胸腔切除.
- 视频辅助右侧小胸切除术为重复手术中额头膜手术提供了重复胸切除术的有效替代方案,并具有可接受的并发症率.
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