右胸前外侧小切口微创二尖瓣置换术

目的：总结右胸前外侧小切口微创二尖瓣置换术45例成功经验。方法：采用右胸前外侧切口（4~6 cm），股动、静脉插管建立体外循环，经胸阻断主动脉，冷血停跳液顺行灌注保护心肌，直视下经左房切口行二尖瓣置换手术。结果：45例患者手术均获成功，无死亡。手术时间80~291（139±35）min；体外循环25~110（49±21）min；升主动脉阻断18~77（33±12）min；术后呼吸机辅助4.5~45（14.8±10）h；胸液引流量50~1 050（262±110）mL；住院5~14（7.5±1.8）d。结论：右胸前外侧小切口二尖瓣置换术安全可靠，创伤小，恢复快，美容效果好。

Minimally invasive mitral valve surgery via right minithoracotomy

ObjectiveTo summarize the successful experience of 45 patients with minimally invasive mitral valve surgery via right minithoracotomy. MethodsForty-five patients with mitral valve disease were enrolled. A main surgical wound (4-6cm)was made over the lateral border of the right breast. Cardiopulmonary bypass was established via femoral cannulation. The Chitwood clamp was inserted thlution the 2nd or 3rd intercostal space. After the cross-clamp was placed, cold blood cardioplegic solution was delivered via right minithoracotomy. The procedures of mitral valve replacement were performed via left atrialotomy. ResultsAll the operations were successful. There was no death. The duration of operation and extracorporeal circulation was 80-291(139±35)min, and 25-110(49±21) min, respectively. The cross-clamped time was 18-77 (33±12) min, the ventilation time was 4.5-45(14.8±10)h, the total chest tube drainage was 50-1 050(262±110)mL, and the postoperative hospital stay was 5-14(7.5±1.8)d.Conclusion Minimally invasive mitral valve surgery via right minithoracotomy is feasible， safe， and less invasive with rapid recovery，and has superior cosmetic results for patients.