全内窥镜机器人修复冠状窦房间隔缺损并同时进行三尖瓣瓣环成形术。

Kazuki Noda, Yosuke Takahashi, Akimasa Morisaki, Yoshito Sakon, Kenta Nishiya, Goki Inno, Yukihiro Nishimoto, Munehide Nagao, Toshihiko Shibata
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摘要

背景:冠状窦型房间隔缺损非常罕见。标准的治疗方法通常是使用传统的胸骨切开术或胸廓切开术切口进行心内修复;然而,机器人技术可以提供一种可行的替代方法,因为它能够为这种异常提供高质量的手术视野:一名 72 岁的男子因无症状的房间隔缺损前来就诊。超声心动图显示,左心房与 CS 直接相通,存在左向右分流,Qp/Qs 比值为 2.1:1。考虑到合并症较少,冠状窦型房间隔缺损适合采用全内镜机器人修复术。我们展示了一例成功的冠状窦型房间隔缺损机器人修复术,同时经右心房进行了三尖瓣瓣环成形术,通过高质量的手术视野正确识别了二尖瓣瓣环和冠状窦之间的边界:对于冠状窦房间隔缺损合并三尖瓣瓣环成形术的病例,机器人修复术是一种可行且治疗效果显著的替代方案。
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Totally endoscopic robotic repair of coronary sinus atrial septal defect with concomitant tricuspid annuloplasty.

Background: The coronary sinus type of atrial septal defect is rare. Standard treatment typically involves intracardiac repair using conventional sternotomy or thoracotomy incisions; however, robotic technology can offer a feasible alternative due to its ability to provide a high-quality surgical view of this anomaly.

Case presentation: A 72-year-old man presented with asymptomatic atrial septal defect. Echocardiography revealed a direct communication between the left atrium and CS with left-to-right shunt flow and a Qp/Qs ratio of 2.1:1. The coronary sinus type of atrial septal defect was indicated for the totally endoscopic robotic repair considering few comorbidities. We present a successful robotic repair of coronary sinus atrial septal defect with concomitant tricuspid annuloplasty via the right atrium, properly identifying the boundary between the mitral annulus and coronary sinus through a high-quality surgical view.

Conclusion: Robotic repair can serve as a viable and therapeutically effective alternative for cases of coronary sinus atrial septal defect with concomitant tricuspid annuloplasty.

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