Objective To summarize the clinical experience of minimally invasive double valve replacement or repair via partial upper hemisternotomy.Methods Five patients with combined aortic valve and mitral valve disease underwent aortic replacement,mitral valve replacement,or repair via partial upper hemisternotomy with cardiopulmonary bypass through femoral artery,femoral vein,and superior vena cava cannulation,under general anesthesia with single lumen endotracheal intubation.Results There were no death cases,prolonged incision,second thoracotomy hemostasis,or tracheal intubation.The operation time was longer than routine operation; cardiopulmonary bypass time,aortic clump time,postoperative mechanical ventilation time,drainage,blood transfusion volume,and ICU time by designed operation were similar to those by routine operation.At 3-month,6-month,and 1-year follow-ups,the valves were with good function and there was no obvious proliferation of incision scar.Conclusion It is safe and feasible to perform double valve surgery via partial upper hemisternotomy.Compared with traditional operation,it can obtain similar therapeutic effect,and the short-term follow-up effect is reliable.
LU Chenxi
,
HUANG Haitao
,
WANG Fei
. Minimally invasive aortic and mitral valve replacement or repair via partial upper hemisternotomy in 5 patients[J]. Surgical Research and New Technique, 2018
, 7(4)
: 247
-249
.
DOI: 10.3969/j.issn.2095-378X.2018.04.007
[1] Bouhout I,Morgant MC,Bouchard D.Minimally invasive heart valve surgery[J].Can J Cardiol,2017,33(9):1129-1137.
[2] Atik FA,Svensson LG,Blackstone EH,et al.Less invasive versus conventional double-valve surgery:a propensity-matched comparison[J].J Thorac Cardiovasc Surg,2011,141(6):1461-1468.
[3] Totaro P,Carlini S,Pozzi M,et a1.Minimally invasive approach for complex cardiac surgery procedures[J].Ann Thorac Surg,2009,88(2):462-466.
[4] Welp HA,Herlemann I,Martens S,et al.Outcomes of aortic valve replacement via partial upper sternotomy versus conventional aortic valve replacement in obese patients[J].Interact Cardiovasc Thorac Surg,2018,27(4):481-486.
[5] Gasparovic I,Artemiou P,Hudec V,et al.Long-term outcomes following minimal invasive versus conventional aortic valve replacement:a propensity match analysis[J].Bratisl Lek Listy,2017,118(8):479-484.
[6] Hillebrand J,Alshakaki M,Martens S,et al.Minimally invasive aortic root replacement with valved conduits through partial upper sternotomy[J].Thorac Cardiovasc Surg,2018,66(4):295-300.
[7] Goebel N,Bonte D,Salehi-Gilani S,et al.Minimally invasive access aortic arch surgery[J].Innovations (Phila),2017,12(5):351-355.
[8] 黄海涛,王飞,陆晨希,等.胸骨上段小切口主动脉瓣膜置换对患者术后心肺功能的影响[J].广东医学,2016,37(5):729-732.
[9] Risteski P,Monsefi N,Miskovic A,et al.Triple valve surgery through a less invasive approach:early and mid-term results[J].Interact Cardiovasc Thorac Surg,2017,24(5):677-682.
[10] 张致琦,赵东,朱仕杰,等.12例右胸骨旁第3肋间小切口行三瓣膜手术的临床经验[J].复旦学报(医学版),2015,42(2):222-225.
