Use of video-assisted thoracoscope in 121 cases of cardiac surgery

作     者：徐学增 俞世强 程云阁 蔡振杰 段大为 王红兵 陈文生 

作者机构：Department of Cardiovascular SurgeryXijing HospitalFourth Military Medical UniversityXi'an 710033China Department of Cardiovascular SurgeryXijing HospitalFourth Military Medical UniversityXi'an 710033Chinabjective: To sum up 121 cases of heart disease operations with the help of thoracoscope from May to August in 2000. Among these cases 48 cases were atrial septal defect (ASD) the average age of patients is 20±10 years old average weight is (43±16) kg. 67 patients with ventricular septal defects (VSD) average age13±9 years old one male patient 44 years old with Ebstein malformation one female patient (21 years old) partial atrioventricu-lar canal combined with cor triatriatum one male (21 years old) with ruptared aneuryem of aortic sinus. 3 cases(all females ) with mitral stenosis combined with mitral valve incompetence. One male patient (aged 16) with pericardiun effusion after trauma. Methods: During operations a patient with supine position and his/her right shoulder was padded 30°higher. Tracheal cannula was inserted and air was piped in with high frequency jet ventilation. Three mini tho-racotomies with a diameter of 2 to 3 cm were made in the 4th intercostals space of the right par sternum and the 4th and 7th intercostals spaces of the right middle axillary line respectively. An periphera extra corporeal circulation was made. the aortic clamp was clamped cannula for cold perfusion. After the heart was sliced and a reformative operation was performed. The process of the operation of defects repairs was finished under the thoracoscope. The other operations were performed with the help of thoracoscope. 3 rheumatic heart disease patients got 25# mechanical mitral valve prosthesis. A 30# tricuspid plasty ring was applied to The Ebstein malformation patient. Results: all 121 patients were successfully operated on without death. Two VSD cases appeared transient third degree atrialventricular block. Because 4 cases had more chest drainage so they were stanched bleeding twice. After the operation heart murmur vanished and ultrasonic inspection showed no diffluence inside the heart. Conclusion: Our experience showed that all atrium ventricular septal defects can be repaired under the thoracoscope. This scope-assisted technology is more accepted by patients because of tiny incisions and also provides an alternative solution for cardiac surgeons. 

出 版 物：《Journal of Medical Colleges of PLA(China)》 (中国人民解放军军医大学学报（英文版）)

年 卷 期：2003年第18卷第5期

页      面：321-324页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：thoracoscope atrial septal defect ventricular septal defect mitral valve replacement 

摘      要：Objective: To sum up 121 cases of heart disease operations with the help of thoracoscope from May to August in 2000. Among these cases, 48 cases were atrial septal defect (ASD); the average age of patients is 20±10 years old; average weight is (43±16) kg. 67 patients with ventricular septal defects (VSD), average age13±9 years old; one male patient, 44 years old with Ebstein malformation; one female patient (21 years old) partial atrioventricular canal combined with cor triatriatum; one male (21 years old) with ruptared aneuryem of aortic sinus. 3 cases(all females ) with mitral stenosis combined with mitral valve incompetence. One male patient(aged 16)with pericardiun effusion after trauma. Methods: During operations, a patient with supine position, and his/her right shoulder was padded 30°higher. Tracheal cannula was inserted and air was piped in with high frequency jet ventilation. Three mini thoracotomies with a diameter of 2 to 3 cm were made in the 4th intercostals space of the right par sternum and the 4th and 7th intercostals spaces of the right middle axillary line respectively. An periphera extra corporeal circulation was made. the aortic clamp was clamped, cannula for cold perfusion. After the heart was sliced and a reformative operation was performed. The process of the operation of defects repairs was finished under the thoracoscope. The other operations were performed with the help of thoracoscope. 3 rheumatic heart disease patients got 25# mechanical mitral valve prosthesis. A 30# tricuspid plasty ring was applied to The Ebstein malformation patient. Results: all 121 patients were successfully operated on without death. Two VSD cases appeared transient third degree atrialventricular *** 4 cases had more chest drainage, so they were stanched bleeding twice. After the operation, heart murmur vanished, and ultrasonic inspection showed no diffluence inside the heart. Conclusion: Our experience showed that all atrium, ventricular septal defects c