房间隔缺损的微创外科治疗

目的观察微创手术治疗房间隔缺损的疗效。方法选择房间隔缺损患者21例,取胸骨右旁第4肋间做3cm切口,切开心包并悬吊,于右心房壁缝双荷包线,并切开,将输送导管(国产)插入右心房内,通过房间隔缺损口入左心房,在经左胸壁超声监视下,释放出房间隔封堵伞,用保险绳做反复牵拉试验,确认封堵伞位置合适,再做一针贯穿右房壁和伞边缘的褥式缝合固定。结果全部患者手术过程顺利,平均手术时间60min,其中平均心内操作15min。患者住院5～7d,术后2～6个月复查,心脏彩超检查封堵伞无移位,无残余分流。结论在经胸壁超声监视下房间隔缺损封堵术是一种微创、安全、简便的治疗方法。

The microinvasive surgical teatment of atrial septal defects

Objective To evaluate the clinical outcome of closing ostium secundum in atrial septal defects(ASD) by microinvasive operation. Methods 21 cases with ASD were operated by microinvasive operation. Incisions of 3 cm were made on the right anterior chest. Operating the pericardium, after right atrial was sutured with double ring, a special occluding device were inserted to close the ostium under the guidance of transesothoricic echocardiography. The satisfiable position of ocluder was comfirmed by tested with the protect string. The right atrial and the ocluder was sutured by a needle thread for fixation. Results All of the patients were successfully occluded. It take 60 min to operate over procedures and 15 min to operate in heart. Patients sday 5-7 days in hospital. The patients were followed up from 2-6 months, no dislocation of the device or atrial shut was found. Conclusion Microinvasive operation of ASD is safe,efficient and convened.