右胸外侧小切口剖胸矫治先天性心脏病12例

[目的 ]介绍在体外循环下经右胸外侧小切口剖胸行心内直视手术的体会 .[方法 ]经右胸外侧第 4肋间进胸 ,矫治先天性心脏畸形 12例 ,其中修补房间隔缺损 2例 ,室间隔缺损 5例 ,法洛氏四联征 4例 ,部分心内膜垫缺损 1例 .[结果 ]全组无手术死亡病例 ,1例法洛氏四联征病例在术后出现低心排综合症 ,3例出现部分右束支传导阻滞 ,1例在房间隔缺损术后拔胸腔引流管时出现气胸 ,再次做胸腔闭式引流 .[结论 ]经右胸外侧小切口手术法可替代正中剖胸矫治先天性心脏畸形手术法 ,它具有损伤小、恢复快、不破坏胸廓连续性及防止术后鸡胸等优点 ,属于微创外科手术 ,值得推广 .

12 cases of congenital heart diseases treated by cardiac open view operation through right side of thorax

OBJECTIVETo introduce the experiece of c ar diac open view operation under the extracorporeal circulation through the right side of thorax with the minimal incision.METHODS12 patients of congenital heart diseases were operated, in which there were 2 cases of ASD, 5 cases of VSD, 4 cases of TOF and 1 case of partial endocardium cushion defect. RESULTSThere were no one case dead in operation. After opera tion there were some complications: lower cardiac output for 1 case and partial right bundle branch block for 3 cases of TOF; residue fistula for 1 case of VSD. CONCLUSIONThe minimal incision operation could replace middl e incision operation in some surgery operations for treatment of congenital hear t diseases. It has some good points of small lesion, quickly recovering, undamag ing the thoracic constinuous and preventing the appearance of pigeon chest.