不停搏心脏直视手术的临床应用

目的 报道６０例不停搏心内直视手术的经验，旨在通过与传统停搏心脏手术的比较，探讨该术式的优点及提高该手术安全性的可行措施。方法 采用静脉复合麻醉，全身肝素化，常规插管，浅低温下建立体外循环，根据病种不同选择手术切口，在心脏搏动状态下进行心内直视畸形矫治术。结果 １例术后４８ｈ出现脑空气栓塞，经高压氧舱治疗２周后恢复。

APPLICATION OF OPEN-HEART SURGERY WITH HEART BEATING

Objective The experiences in 60 cases of open-heart operation with heart beating were reviewed. The advantages of the operation, precautions and avoidance of air embolism were discussed by comparing with the conventional open -heart procedure. Methods All the patients were under general anesthesia and heparinized. The establishment of extrocorporeal circulation and direct - vision cardiac operations with heart beating were employed in all patients with heart incision adopted according to the varied types of heart deformation. Results All patients recovered satisfactorily with no low cardiac output syndrome, atrioventricular block or severe arrhythmia. Only in 1 case of ventricular septal defect, cerebral air embolism developed 2 days after operation, which was cured by two-week hyperbaric oxygenation. Conclusion These procedures can effectively attenuate cardiac ischemic and reperfusion injury and atrioventricular block,compared with conventional cardiac operation. The operation is much more suitable for the repair of right heart deformation. The maintenance of higher aortic perfusion pressure intraoperatively must be emphasized to decrease the likelihood of air embolism.