右乳房下小切口行常见先天性心脏病矫治术

目的：观察用右乳下小切口代替胸部正中切口行心脏直视手术效果。方法：经右乳房下小切口，用常规的动、静脉插管建立体外循环，为１６例先天性心脏病患者施行了矫正手术。结果：１６例均手术成功，伤口均一期愈合，无死亡。平均阻断主动脉时间２０８ｍｉｎ，平均手术时间１６０ｍｉｎ，术后平均拔除气管插管时间６ｈ，术后引流量５０ｍｌ～１５０ｍｌ（３例除外），平均住院时间１０ｄ。结论：应用右乳房下小切口，不需要用特殊的动、静脉插管及微创器械，用常规建立体外循环的方法，可以顺利完成常规先天性心脏病手术，缩短进胸、关胸时间，患者痛苦小，伤口美观，恢复快。

CORRECTION OF COMMON CONGENITAL HEART DISEASE THROUGH A SMALL RIGHT SUBMAMMARY INCISION

Objective:To decrease the postoperative suffer and to avoid the complication of sternum dehiscence with excellent cosmetic effectiveness in the patients with correction of common congenital heart disease who underwent a small right submammay incision in stead of the traditional median sternotomy. Methods:Sixteen patients with congenital heart disease underwent the small right submammay incision.All of the operations were finished by a routine establishment of cardiopulmonary bypass(CPB) without any special arterial and venous cannulas. Results:All the patients were succeeded with the wound healed primarily and without perioperative mortality.The mean aortic clamp time was 20 8 minutes,the mean operation time was 160 minutes,the mean tracheal detubation time was six hours,the drainage volume was from 50 ml to 150 ml(except for three patients),and the mean hospital stay time was 10 days.Conclusion:The common congenital heart disease can be performed smoothly under a routing establishment of CPB by a small right submammay incision without any special arterial and venous cannulas and minimal invasive instruments.The time of opening and closing chest was shortened.The patient had less postoperative suffer,cosmetic incision and recovered rapidly.It is important to carefully close right atrial incision and to have a correct diagnosis preoperatively.