通过右腋下胸廓切开术进行升主动脉和主动脉瓣同时置换的微创视频辅助手术

Shuwei Wang, Chentao Luo, Bing Zhou, Zhibin Hu, Zhifang Liu, Erlei Han, Changhao Wu, Fuyang Mei, Xiaofeng Lu, Weikang Chen, Zhiqiang Dong, Yong Cui
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引用次数: 0

摘要

研究目的本研究旨在评估一种创新的右侧腋下 4 厘米切口方法用于同时进行升主动脉和主动脉瓣置换术(AAR 和 AVR)的安全性、有效性和美学效果,重点是在确保最小可见瘢痕的同时实现最佳手术效果:我们回顾性地检查了 2021 年 7 月至 2023 年 6 月期间在我院进行的所有同期升主动脉瓣和主动脉瓣置换术的择期手术病例。不包括急诊手术、急性 A 型主动脉夹层、活动性主动脉瓣心内膜炎、重做心脏手术、必须同时进行二尖瓣置换术或左室辅助装置植入术。我们收集并分析了患者的围手术期数据:研究共包括 24 名连续患者。心肺旁路时间和主动脉交叉钳夹时间分别平均为 215.0 分钟(四分位距[IQR],38.0)和 158.0 分钟(四分位距[IQR],37.0)。没有因术后出血或需要植入永久起搏器而再次手术的记录。术后 24 小时初始引流量平均为 186.9 ± 76.9 mL。平均随访时间为 21.7 ± 6.2 个月(5 至 30 个月)。在整个短期随访过程中,没有观察到瓣膜功能障碍、瓣膜旁漏、需要再次入院的心血管事件或死亡:结论:右腋下切口方法能有效地为同时进行的 AAR 和 AVR 带来安全、成功和美观的结果。有必要进行进一步的研究和比较,以验证这些发现。
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Minimally Invasive Video-Assisted Surgery for Concomitant Ascending Aorta and Aortic Valve Replacement via Right Infra-Axillary Thoracotomy.

Objective: This study aims to assess the safety, efficacy, and esthetic outcomes of an innovative 4 cm right infra-axillary incision approach for concomitant ascending aorta and aortic valve replacement (AAR and AVR), with a specific focus on achieving optimal surgical outcomes while ensuring minimal visible scarring.

Methods: We retrospectively examined all elective cases of concomitant AAR and AVR surgery performed at our institution from July 2021 to June 2023. Exclusions encompassed emergency surgery, acute type A aortic dissection, active aortic valve endocarditis, redo cardiac surgery, the necessity for concurrent mitral valve replacement, or left ventricular assist device implantation. We collected and analyzed perioperative data for the patients.

Results: The study comprised 24 consecutive patients. Cardiopulmonary bypass time and aortic cross-clamp time averaged 215.0 (interquartile range [IQR], 38.0) and 158.0 (IQR, 37.0) min, respectively. No instances of reoperation due to postoperative bleeding or need for permanent pacemaker implantation were recorded. Initial 24-h postoperative drainage volume averaged 186.9 ± 76.9 mL. Average follow-up duration was 21.7 ± 6.2 months (range, 5 to 30 months). Throughout short-term follow-up, no occurrences of valve dysfunction, paravalvular leak, cardiovascular events necessitating readmission, or mortality were observed.

Conclusions: The right infra-axillary incision approach effectively yields secure, successful, and cosmetically pleasing outcomes for concomitant AAR and AVR. Further research and comparisons are warranted to validate these findings.

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来源期刊
CiteScore
2.00
自引率
6.70%
发文量
80
期刊介绍: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery is the first journal whose main mission is to disseminate information specifically about advances in technology and techniques that lead to less invasive treatment of cardiothoracic and vascular disease. It delivers cutting edge original research, reviews, essays, case reports, and editorials from the pioneers and experts in the field of minimally invasive cardiothoracic and vascular disease, including biomedical engineers. Also included are papers presented at the annual ISMICS meeting. Official Journal of the International Society for Minimally Invasive Cardiothoracic Surgery
期刊最新文献
Minimally Invasive Video-Assisted Surgery for Concomitant Ascending Aorta and Aortic Valve Replacement via Right Infra-Axillary Thoracotomy. Results of Vertical Infra-Axillary Thoracotomy for Total Repair of Tetralogy of Fallot. The 10 Commandments for the Ross Procedure. Dealing With the Aortic Annulus: Surgical Aortic Annulus Enlargement With a Ballon Catheter. A Risk Prediction Model for Prolonged Length of Stay After Minimally Invasive Valve Surgery.
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