胸骨小切口微创心脏瓣膜手术

背景：微创心脏手术具有创伤小、疼痛轻、恢复快、出血少,美学效果好,医疗费用低等优点。方法：１９９８年８月￣１９９９年１０月共施行微创心瓣膜手术１５例,平均年龄４１岁。风心病１１例,退行性变２例,先天性心脏病１例,细菌性心内膜炎１例。心功能Ⅱ级１例,Ⅲ级１４例。胸骨上端部分劈开（Ｊ形切口）１０例,胸骨下端部分劈开５例。进行主动脉瓣替换术２例,二尖瓣替换术１０例,二尖瓣成形术３例,同期行三尖瓣成形术２

Minimal Invasive Valve Surgery Through Ministernotomy

Background: Minimal invasive valve surgery developed in the 1990 s possesses the advantages of less pain, quick recovery, less bleeding and trans fusion, improved cosmeses, and lower cost. Methods: From August 1998 to October 1999, fifteen patients (rheumatic 11, degenerative 2, congenital 1, bacterial 1) underwent minimal invasive heart valve surgery, in which 10 cases had mitral valve replacement, 3 mitral valvuloplasty, and 2 aortic valve replacement with concomitant tricuspid valvuloplasty (2 cases) and sinal septal defect repair (1 case). Ten patients were operated on through upper partial sternotomy ("J" incision) and five patients through lower half stemotomy. Results: There were no operative mortality and morbidity. The mean bypass and aortic cross clamp times were 87. 8 minutes and 54. 5 minutes, respectively. The mean volumes of chest drainage and blood transfusion were 430 ml and 266 ml, respectively. The mean ICU stay was 1. 1 days and the patients were discharged 6. 8 days postoperatively. Conclusion: Minima invasive heart valve surgery is a safe, effective procedure with comparable results of conventional heart valve surgery. It also decreases the surgical trauma and cost.