经右前外侧肋间小切口心脏多瓣膜手术154例中期疗效随访的回顾性队列研究

目的 分析经右前外侧肋间小切口心脏多瓣膜手术的早期疗效中期随访结果,探讨手术的安全性、有效性与外科医生学习曲线.方法 回顾性分析2015～2019年空军军医大学第一附属医院心血管外科完成的154例经右前外侧肋间小切口多瓣膜手术的临床资料.男103例,女51例,年龄23 ～ 68岁,全部手术经股动、静脉建立闭式体外循环,...

The therapeutic effect and mid-term follow-up of 154 patients of multiple valvular surgery through right anterolateral intercostal thoracotomy:A retrospective cohort study

Objective To investigate the therapeutic effect,safety and effectiveness of multiple valvular surgery through right anterolateral intercostal thoracotomy,as well as the mid-term follow-up results and surgeon's learning curve.Methods The clinical data of 154 patients with multiple valvular disease were performed minimally invasive cardiac surgery in the Department of Cardiovascular Surgery,The First Affiliated Hospital of Air Force Medical University,from 2015 to 2019 were retrospectively analyzed.There were 103 males and 51 females,aged 23-68 years.Closed cardiopulmonary bypass was established through femoral artery and femoral vein,and the thoracic cavity was entered through a 6 cm transverse incision in the fourth intercostal space on the right side of sternum.Baseline and perioperative characteristics and postoperative outcomes were reviewed.Results There was no perioperative death.The average cardiopulmonary bypass time was 159.3±39.4 min,and the aortic clamping time was 102.3±20.3 min.One patient underwent thoracotomy during the operation,and two patients underwent second thoracotomy for hemostasis.During the follow-up period of 10-55 months,1 patient died,2 patients developed mild perivalvular regurgitation,6 patients developed moderate tricuspid regurgitation,and no serious cardiovascular events occurred in the rest of the patients.Conclusion Our findings demonstrate that multiple valvular surgery through right anterolateral intercostal thoracotomy is safe,and in an acceptable risk of complication.The early and middle follow-up results are satisfactory.The minimally invasive cardiac surgery can also meet the requirements of cosmetology,and is conducive to the recovery of patients'mental and physical health.This method is worthy of application in medical centers with rich experience in routine cardiac surgery.