通过右胸腔切除术进行复手性门手术的结果
1Section of Thoracic Surgery, University of Michigan Medical Center, Ann Arbor, USA.
Circulation
|November 1, 1996
概括
右胸切除术为重复手术中枢门手术提供了一个安全的替代方案,减少了与重复中枢切除术相关的风险. 这种方法有利于需要重复心脏门手术的选定患者.
科学领域:
- 心血管外科心血管外科
- 胸部外科手术 胸部外科手术
- 心脏门的修复和更换
背景情况:
- 在先前的心脏手术后,复手手术的二手或三门手术率越来越高.
- 与重复手术中枢骨切除术相关的重大风险,包括移植损伤,骨脱落和心脏损伤.
研究的目的:
- 评价右胸切除术方法的安全性和可行性,用于重复手术的二手和三脚门手术.
- 在需要重复心脏门手术的患者中,提供中间椎切除的替代方案.
主要方法:
- 通过右胸切除术 (1990年1月 - 1995年9月) 对62名经历了重复手术的二手或三门手术的患者进行了回顾性分析.
- 程序包括 mitra 门的修复/更换和三门的修复.
- 使用上升性大动脉或大腿动脉管与双角静脉排水,全身冷却和纤维动脉停止.
主要成果:
- 6.4% 30天住院死亡率 (1次手术,4次住院死亡).
- 并发症率低;只有1名患者需要重新检查出血.
- 平均27个月的随访显示,幸存者在纽约心脏协会I或II级.
结论:
- 右胸切除术是选择的重复手术中枢门手术患者中枢骨切除术的安全和可行的替代方案.
- 当重复中侧骨切除术带来重大危险时,应考虑这种方法.
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