经胸骨小切口主动脉根部置换术

目的比较经胸骨小切口主动脉根部置换术与经传统切口手术的临床结果。方法1999年7月至2001年10月行。Bentall手术60例。采用胸骨小切口15例，传统胸骨正中切口45例。结果两组病例均无围手术期死亡。术后早期并发症发生率两组间差异无显著性(P=0．661)。小切口组的手术时间及体外循环时间长于传统切口组(P=0．027，P=0．015)。小切口组的机械通气时间、输血量、未输库存血率、胸腔引流量及总住院时间均优于传统切口组，但差异无显著性。结论经小切口的Bentall手术，不增加手术风险。胸骨上段小切口适用于Bentall手术及部分弓置换术，胸骨下段小切口适用于心脏巨大或同期行心内畸形的矫治者。

Aortic root replacement by ministernotomy

Objective: To compare the clinical outcome between ministernotomy and standard median sternotomy in aortic root replacement. Methods: A total of 60 patients underwent aortic root replacement (ARR) between July 1999 and October 2001 in Fu Wai Hospital. 15 patients who underwent ARR by ministernotomy were defined as the MINI group. The comparable group was 45 patients who underwent ARR by standard median sternotomy (STD group). Results: There was no post-operative death in each group. Early postoperative complications occurred in 3 (20.0%) of the MINI group and in 5 (11.1%) of the STD group (P= 0.661). In the MINI group, both the mean opera ting time and the cardiopulmonary bypass time were significantly longer than that in STD group (P=0.027, P=0.015). There was no significantly difference in ao rtic cross-clamping time between two groups. In the MINI group, the mean intubation time, postoperative blood transfusion amount, the mediastinal drainage and duration of hospital stay were less than that of the STD group. But, they all showed no statistical significant differences. Conclusion: Both approaches for patients undergoing AAR resulted in acceptable morbidity. AAR by ministernotomy provides a potential benefit of less trauma and reduction of blood transfusion.