24例微创主动脉瓣置换术临床分析

目的:探讨采用PORT ACCESS技术,进行微创主动脉瓣置换手术的安全性。方法:回顾性分析我院2010年6月至2012年5月期间,24例微创主动脉瓣替换术患者的临床资料,并与48例传统正中开胸主动脉瓣置换患者资料作对比性研究。结果:微创组虽然在平均体外循环时间、主动脉阻断时间[(124±39)vs.(102±34)min;(97±33)vs.(83±24)min]较传统正中开胸组长,两组患者在手术时间差异无统计学意义。微创组在减少手术输血量、平均住ICU时间、平均住院时间[(8 vs.38)mL;(1.2±0.6)vs.(2.5±1.7)d;(11.1±4.3)vs.(19.7±7.8)d]上优于传统正中开胸组。结论:微创主动脉瓣置术换创伤小、术中输血少、术后恢复快,是治疗主动脉瓣疾病安全选择。

Minimally invasive aortic valve replacement surgery of 24 patients

Objective:To assess the safety and clinical outcomes of port-access aortic valve replacement( PAVR). Methods: Records of 24 patients having PAVR between June,2010 and October,2012 were reviewed. Results were compared with 48 patients having conventional aortic valve replacement( CAVR) with midline sternotomy. Result: Although cardiopulmonary bypass time and cross-clamp time were longer in the PAVR group [( 124 ± 39) vs.( 102 ± 34) min;( 97 ± 33) vs.( 83 ± 24) min],there were no significant differences in total operative time between the CAVR and PAVR groups. With regard to the percentage of blood transfusion requirement,intensive care unit stay and hospital stay the PAVR group had significantly lower outcomes[( 8 vs. 38) mL;( 1. 2 ± 0. 6) vs.( 2. 5 ± 1. 7) days;( 11. 1 ± 4. 3) vs.( 19. 7 ± 7. 8) days respectively]. Conclusion: PAVR has small incision,less need for blood transfusion and shorter length of hospital stay and less need for blood transfusion. It is a feasible treatment of choice for patients with aortic valve diseases.