【摘要】 目的探讨体外循环下完全胸腔镜下心脏手术的安全性及疗效。方法 2008年10月～2010年5月行完全胸腔镜下心脏手术46例,其中单纯房间隔缺损25例、室间隔缺损21例。右侧胸壁3孔分别为:右侧胸骨旁第4肋间为第1切口长约2cm;右侧腋中线第3肋间做第2切口长1.5～2.5cm;右侧腋中线第7肋间做第3切口长2～3cm。股动脉及股静脉插管建立体外循环。结果手术均获成功,体外循环时间(64±26)min;升主动脉阻断时间(38±11)min;术后胸腔闭式引流量(110±60)ml。无严重并发症发生。46例随访0.5～1.5年,无死亡及残余分流。结论全胸腔镜下手术治疗房、室间隔缺损安全,疗效满意。更多还原

【Abstract】 Objective To evaluate the efficacy and safety of thoracoscopic cardiac surgery under extracorporeal circulation.Methods From October 2008 to May 2010,46 patients,including 25 cases of atrial septal defect,and 21 cases of ventricular septal defect,received thoracoscopic cardiac surgery under extracorporeal circulation in our department.The procedures were performed with 3 trocars through incisions at the right parasternal fourth intercostal space(2 cm),third intercostal space at the right middle axillary line(1.5-2.5 cm),and seventh intercostal space at the right middle axillary line(2-3 cm).Meanwhile,catheters were placed into the right femoral artery and vein to set up extracorporeal circulation.Results All the thoracoscopic operations were completed successfully.The mean extracorporeal circulation and cross-clamping time were(64±26)min and(38±11)min respectively.The volume of chest drainage was(110±60)ml.No severe complications occurred in this series.The patients were followed up for 0.5 to 1.5 years,during which no death or remnant shunt was observed.Conclusion Thoracoscopic cardiac surgical is feasible,safe,and minimal invasive for patients with ASD or VSD.更多还原