心脏不停跳心内直视手术113例

目的探讨不停跳心内直视手术的方法和意义。方法浅低温（31℃-34℃）不停跳心脏直视手术共113例,男59例,女54例。年龄4-73岁,平均31.4岁。其中房间隔缺损（atrial septal defect,ASD）22例,室间隔缺损（ventricular septal defect,VSD）32例,法乐氏三联征（triad of Fallot,F3）3例,双腔右心室1例,Ebstein畸形3例,二尖瓣置换手术（mitral valve replacement,MVR）36例,主动脉瓣置换手术（aortic valve replacement,AVR）9例,双瓣置换手术（double valves replacemnet,DVR）7例。结果1例二尖瓣置换手术因术中暴露极差而被迫降温心脏停跳操作外,其余全为非停跳手术,全组手术顺利,无死亡,术后恢复良好。结论心脏不停跳手术简化了手术操作程序,方便手术后管理,减少了心脏停跳后的负面影响。

Clinic study on 113 cases on beating heart surgery during cardiopulmonary bypass

Objective To evaluate the effects of beating heart surgery during cardiopulmonary bypass.Methods One hundred and thirteen patients received surgery under mild hypothermia during CPB(males 59,females 54): Atrial septal defect(ASD) in 22 cases,ventricular septal defect(VSD) in 32 cases,triad of Fallot in 3 cases,double chamber right ventricle in 1 case,Ebstein anomaly in 3 cases,mitral valve replacement(MVR) in 36 cases,aortic valve replacement(AVR) in 9 cases and double valves replacement(DVR) in 7 cases respectively.Results One case of MVR had to change arrested heart during operation because of poor exposure,112 cases were successful in beating heart surgery during CPB.There were no in-hospital deaths.Conclusion The advantages of beating heart surgery during CPB are simplified operational procedure,the possibility for examining the effect of operation in congenital heart diseases,diminishing the negative effect of arrest heart operation.