微创小切口心内直视手术(附358例报告)

目的：探讨微创小切口心内直视手术治疗的经验。方法：对1997-10～2002-06进行的358例微创小切口心内直视手术进行回顾性分析。其中继发孔房间隔缺损(ASD)147例，合并三尖瓣关闭不全(TI)31例，合并动脉导管未闭(PDA)13例，合并室间隔缺损(VSD)32例，合并部分肺静脉异位引流(PAPVD)4例；VSD166例，合并右室双腔心(DCRV)7例，PDA8例；肺动脉瓣狭窄(PS)3例；法乐氏三联症4例；法乐氏四联症(TOF)2例；二尖瓣狭窄伴关闭不全(MVD)29例；左房粘液瘤(LAM)7例。结果：死亡2例，死亡率0．6％(2／358)，均与手术方式无关。结论：微创小切口心内直视手术创伤小、美观、痛苦少、恢复快、安全有效，但应严格掌握手术适应证及合理选择手术切口。

Experience of minimally invasive incision in cardiac surgical practice with 358 cases

Objective: To probe the experience of minimally invasive incision for open-heart surgery. Methods:From Oct.1997 to Jun.2002,358 cases being operated through minimal approach were analyzed retrospectively. Including 147 cases of atrial septal defect (ASD), 166 cases of ventricular septal defect (VSD), 3 cases of pulmonary arterial stenosis(PS), 4 cases of trilogy of fallot, 2 cases of tetralogy of fallot(TOF), 29 cases of stenosis and insufficiency of mitral valve and 7 cases of left atrial myxomas(LAM). Results: There were two post-operative death and the death rate was 0.6%(2/358),in which one patient died of cerebral bleeding and one of pulmonary hypertension.WT5HZ]Conclusion: Minimally invasive incision is a safe, effective technique with less pain and may shorten the hospital stay.