经食管超声心动图在机器人辅助心脏手术中的应用价值

目的应用经食管超声心动图（TEE）监测、指导机器人辅助心脏手术，在微创环境下，使手术完美成功。方法8例机器人辅助心脏手术患者均在手术切口前将探头插人食管内，待机器人辅助手术开始，整个手术过程中与机器人的监视器同步进行TEE监测、指导机器人辅助手术。结果4例房间隔缺损修补、3例房间隔缺损封堵和1例二尖瓣置换术均获得成功，术后即刻TEE检查均未见残余分流、瓣周漏及瓣膜反流。结论机器人辅助心脏手术，在TEE监测和指导下机械手能准确、无误地到位缝合、修补，释放封堵器，同时可观察有无残余分流、瓣周漏及瓣膜反流，一旦缝合、修补不足可及时纠治，确保手术成功。

Evaluation of transesophageal echocardiography in minimally invasive cardiac surgery

Objective To study the feasibility and effectiveness of transesophageal echocardiography(TEE) in monitoring robotic-assisted minimally invasive cardiac surgery.Methods Eight patients were chosen to apply for AESOP 3000 computer-assisted mini-invasive surgery.Three of seven patients with atrial septal defect(ASD) were treated with Amplatzer occluder,and four were approached with repair,and one patient with mitral valve stenosis and regurgitation was underwent replacement.TEE was performed to monitor intracardiac robotic arms suture,assess intra-operative blood flow,and direct treatment approach in the whole process of operation.Results All patients were successfully completed operation.Intraoperative TEE contributed to robotic arms manipulation.No residual shunt,peri-prosthetic leakage,or valve regurgitation was found after operation.Conclusions During robotic-assisted micro-invasive cardiac surgery,TEE is feasible to guide catheter sheath manipulation and occluder release,moniter peri-valve leakage,and evaluate valve regurgitation.