【摘要】 目的:探讨经右外侧小切口剖胸体外循环矫治先天性心脏畸形的经验。方法:1996年6月至2002年1月共完成经胸右外侧第4肋间小切口进胸,体外循环下先天性心脏畸形矫治术102例。开展手术的病种包括房间隔缺损40例(合并三尖瓣关闭不全2例,完全肺动脉畸形引流入右心房1例,肺动脉狭窄3例),室间隔缺损53例(合并二尖瓣关闭不全2例,三尖瓣关闭不全9例,右室流出道狭窄3例,肺动脉狭窄1例),心内膜垫缺损4例,法乐四联症4例,动脉导管未闭手术后残余分流合并主动脉下狭窄1例。体外循环时间平均60.7分±33.2分(15分-168分),心肌阻断时间31.9分±24.3分(3分-117分),手术后住院天数6.3天±8.6天(4天-15天)。结果:全组患者无手术死亡。结论:经由胸右外侧小切口矫治先天性心脏畸形手术具有创伤小、出血少、斑痕隐蔽、不破坏胸廓的骨性连续性,防止手术发生鸡胸,美观效果好于胸部正中切口等优点。更多还原

【Abstract】 Objective: To review the experience of correction of congenital cardiac defects though a righ minithoracotomy. Method: 102 patients underwent correction of congenital heart malformations thought right lateral thoracotomy under cardiopulmonary bypass. The heart malformations repaired included atrial septal defect in 40 (2 patients with tricuspid insufficiency, Itotally anomalous pulmonary venous connection, 3 pulmonary stenosis), ventricular septal defect in 53(2 patients with mitral insufficiency, 9 tricuspid insufficiency, 3 right ventricular outflow tract obstrction,8 pulmonary stenosis),Pallot’s Tetralogy in 4,endocardial cushion defect in 4, coexisting patent ductus arteriosus and aorta stenosis in 1. The mean cardiopulmonary bypass time was 60.7±33. 2 min( range 15-168 min), and the mean aotic crossclamping time was 31.9±24. 3 min(3-117 min. ), and the mean postoperative hospitas stay was 6.3±8.6 days(4-15 days). Result:No operative mortility and severe postoperative complications were note. Conclusion: The right lateral thoracotomy is a safe and effective alternative to a median stemotmy for correction of cardiac defects. Advantages of this approach include less injury,less bleeding, maintaining the continuity and the integrity of the bony thorax,and preventing postoperative pigeon breast. The cosmetic result is superior to that of median sternotmy.更多还原