右侧腋下直切口在二次心脏瓣膜手术中的应用_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

王强 , 李凯 , 潘俊 , 曹海龙 , 范阜东 , 周庆 ,  王东进

南京大学医学院附属鼓楼医院心胸外科（南京 210008）;

Corresponding author：

王东进, Email: gldjw@163.com

Keywords：

右腋下直小切口; 二次心脏手术; 瓣膜手术

DOI：

10.7507/1007-4848.201706024

Video：

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目的探讨右侧腋下直切口在二次心脏瓣膜手术中的应用效果。方法回顾性分析2014 年 1 月至 2016 年 12 月我院经右侧腋下直切口行二次心脏瓣膜手术 23 例患者的临床资料，男 9 例、女 14 例，年龄 37～67 岁，平均（54.0±9.1）岁，体重 43～73 （56.0±9.8）kg。手术方式包括二尖瓣置换（MVR）7 例，二尖瓣成形（MVP）1 例，主动脉瓣置换（AVR）3 例，三尖瓣成形术（TVP）4 例，三尖瓣置换术（TVR）2 例，MVR+TVP 2 例。结果本组平均手术时间 3～6（4.6±0.9）h，体外循环时间 55～140（104.8±22.3） min。心脏停跳术后自动复跳 17 例（17/23），气管插管时间 4～24（12.2±6.0）h，手术后住院时间平均（7.5±1.9）d。手术后首日引流量平均（404.3±204.0）ml。17 例患者术后无输血（17/23）。本组患者无围术期死亡，无明显并发症出现。出院时心功能 Ⅰ 级 13 例、Ⅱ 级 10 例。结论经右侧腋下直切口在二次心脏瓣膜手术中的近期手术效果良好，手术安全性高，适用于常见二次心脏瓣膜手术。

Citation： 王强, 李凯, 潘俊, 曹海龙, 范阜东, 周庆, 王东进. 右侧腋下直切口在二次心脏瓣膜手术中的应用. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2018, 25(6): 536-538. doi: 10.7507/1007-4848.201706024 Copy

1.	Head SJ, Çelik M, Kappetein AP. Kappetein. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28):2183-2191.
2.	李平, 尤斌, 高峰, 等. 经右胸小切口在二次心脏手术中的应用. 心肺血管病杂志, 2015, 34(6): 465-469.
3.	Celiento M, Blasi S, De Martino A, et al. The mosaic mitral valve bioprosthesis: A long-term clinical and hemodynamic follow-up. Tex Heart Inst J, 2016, 43(1): 13-19.
4.	Wang H, Liu X, Wang X, et al. Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease. J Thorac Dis, 2016, 8(11): 3087-3095.
5.	Onorati F, Perrotti A, Reichart D, et al. Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience. Eur J Cardiothorac Surg, 2016, 49(5): e127-e133.
6.	王潇, 陶凉, 陈绪发, 等. 右胸微创小切口二尖瓣置换术与传统二尖瓣置换术的对比分析. 中国胸心血管外科临床杂志, 2013, 20 (2): 139-143.
7.	Xu C, Pan J, Zhou Q, et al. Right vertical infra-axillary thoracotomy for double valve replacement. J Card Surg, 2015, 30(5): 427-430.
8.	Yaliniz H, Topcuoglu MS, Gocen U, et al. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects. Asian J Surg, 2015, 38(4): 199-204.
9.	李庆国, 潘俊, 王强, 等. 右腋下直小切口心内直视手术的解剖学基础与临床应用. 中国临床解剖学杂志, 2012, 29(1): 108-110.
10.	Pan J, Li QG, Zhou Q, et al. Aortopulmonary window with subaortic fibrous stenosis and septal defect: surgery through a minimal right vertical infra-axillary thoracotomy. Heart Surg Forum, 2011, 14(4): E264-E266.

1. Head SJ, Çelik M, Kappetein AP. Kappetein. Mechanical versus bioprosthetic aortic valve replacement. Eur Heart J, 2017, 38(28):2183-2191.
2. 李平, 尤斌, 高峰, 等. 经右胸小切口在二次心脏手术中的应用. 心肺血管病杂志, 2015, 34(6): 465-469.
3. Celiento M, Blasi S, De Martino A, et al. The mosaic mitral valve bioprosthesis: A long-term clinical and hemodynamic follow-up. Tex Heart Inst J, 2016, 43(1): 13-19.
4. Wang H, Liu X, Wang X, et al. Comparison of outcomes of tricuspid annuloplasty with 3D-rigid versus flexible prosthetic ring for functional tricuspid regurgitation secondary to rheumatic mitral valve disease. J Thorac Dis, 2016, 8(11): 3087-3095.
5. Onorati F, Perrotti A, Reichart D, et al. Surgical factors and complications affecting hospital outcome in redo mitral surgery: insights from a multicentre experience. Eur J Cardiothorac Surg, 2016, 49(5): e127-e133.
6. 王潇, 陶凉, 陈绪发, 等. 右胸微创小切口二尖瓣置换术与传统二尖瓣置换术的对比分析. 中国胸心血管外科临床杂志, 2013, 20 (2): 139-143.
7. Xu C, Pan J, Zhou Q, et al. Right vertical infra-axillary thoracotomy for double valve replacement. J Card Surg, 2015, 30(5): 427-430.
8. Yaliniz H, Topcuoglu MS, Gocen U, et al. Comparison between minimal right vertical infra-axillary thoracotomy and standard median sternotomy for repair of atrial septal defects. Asian J Surg, 2015, 38(4): 199-204.
9. 李庆国, 潘俊, 王强, 等. 右腋下直小切口心内直视手术的解剖学基础与临床应用. 中国临床解剖学杂志, 2012, 29(1): 108-110.
10. Pan J, Li QG, Zhou Q, et al. Aortopulmonary window with subaortic fibrous stenosis and septal defect: surgery through a minimal right vertical infra-axillary thoracotomy. Heart Surg Forum, 2011, 14(4): E264-E266.

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右侧腋下直切口在二次心脏瓣膜手术中的应用

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