完全胸腔镜辅助下体外循环在心脏手术中的应用(附133例报告)

目的：总结体外循环完全胸腔镜下心脏手术的体外循环建立方法和体外循环的管理。方法：分析133例心脏病患借助于电视胸腔镜进行房间隔缺损修补，室间隔缺损修补，二尖瓣置换，Ebstein畸形矫治．部分房室管畸形的体外循环过程和术后结果．结果：1例患停体外循环后因血氧饱和度偏低，延长第4肋间切口探查；1例因手术操作导致出血而延长切口再次插管建立体外循环；2例患因残余漏再次手术，其余129例患手术过程顺利。133例患术后均恢复良好。结论：胸壁打孔体外循环下完全借助于电视胸腔镜实施心脏手术安全、可行；开展此手术的初期体外循环时间和主动脉阻闭时间相对较长，应加强体外循环的管理。

Report of 133 cases: Application of cardiopulmonary bypass with totally videoassisted thoracoscopy in heart operation

AIM: To summarize the way and management of cardiopulmonary bypass (CPB) with totally video assisted thoracoscopy in heart operation. METHODS: The process and postoperative results of 133 patients undergoing operation of CPB with totally video assisted thoracoscopy were analyzed. The patients involved were 57 cases of atria septal defect, 70 ventricular septal defect, 3 mitral valve stenosis, 1 Ebstein deformed and 1 partia atrioventri cular canal defect. RESULTS: Of the 133 cases, two patients were reoperated because of the residual shuntos of ventricular septal defect. The incison of another two patients were extende during operation because of low saturation of peripheral arteries and aorta wall bleeding. The rest 129 cases were successfully operated by applying . cardiopulmonary bypass with totally video assisted thoracoscopy. All patients recovered well postoperatively and discharged uneventfully. CONCLUSION: Heart operations can be done by applying cardiopulmonary bypass with totally video assisted thoracoscopy. The method is safe and practicable. But it should be modified to shorten the duration of CPB and aorta clamping.