左后外侧切口在再次二尖瓣手术中的应用

目的 介绍左后外侧剖胸切口、降主动脉肺动脉转流在再次二尖瓣手术中的应用。方法 1995-04～2003-04在本院住院的11例曾经进行过二尖瓣手术，术后复发性二尖瓣患者，采用左后外侧剖胸切口，以降主动脉肺动脉转流建立体外循环的方法实施心内操作。结果 全部病人均未阻断主动脉，平均转流时间138分，术后引流少于300ml，病人均痊愈出院。结论 对于术后复发性二尖瓣病进行再次手术时，应用左后外侧剖胸切口，避开了原胸骨正中切口，减少了粘连的分离，手术操作简便，术野显露满意。

Application of Left Posterior Lateral Thoracotomy in Reoperation of Mitral Valve

Objective To explore the application of left posterior lateral thoracotomy in the reoperation of mitral vavle. Methods Between April 1995 and April 2003, 11 cases of postoperative recurred mitral valve diseases received reoperation through a left posterior lateral thoracotomy under cardiopulmonary bypass via descending aorta for artery line and main pulmonary artery cannulation for venous line. Results There were no operative and post-operative deaths. The mean CPB time was 138 min. Blood loss of postoperation was less than 300ml in each patient. Conclusion Left posterior lateral thoracotomy in the reoperation of postoperative recurred mitral valve diseases had a minimal adhesiotomy. Extracorporeal circulation via descending aorta and main pulmonary artery cannulation proved easy to do and reliable. This operative approach was simple and safe.