[Minimally invasive thoracic aortic surgery: our experience].

IF 0.7 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Olimpia Bifulco, Paolo Berretta, Simone D'Alessio, Martina Giusti, Filippo Capestro, Alessandro D'Alfonso, Pietro Giorgio Malvindi, Marco Di Eusanio
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引用次数: 0

Abstract

Background: The growing experience in minimally invasive techniques, supported by outstanding outcomes and excellent surgical exposure of the entire proximal thoracic aorta via ministernotomy, has motivated surgeons to apply this approach to more challenging procedures such as aortic root and arch treatment.

Methods: From September 2016 to April 2024, 243 consecutive patients underwent proximal aortic surgical treatment through the ministernotomy approach at the Cardiac Surgery Unit of the Lancisi Cardiovascular Center of Ancona - Polytechnic University of Marche, Italy. In all cases, a preoperative computed tomography scan was performed.

Results: The mean age of the population was 65 ± 12 years, and 176 patients (72%) were male. Aortic valve disease occurred in 66.9% of cases (n=85) with significant aortic valve regurgitation or stenosis in 127 (52%) and 44 (18%) patients, respectively. Bicuspid aortic valve was found in 29% of patients (n=70). Surgical procedures included aortic root operations (n=88) using Bentall (n=64) or David (n=24) technique, isolated replacement of the ascending aorta (n=73), and combined treatment: replacement of the ascending aorta and the aortic valve (n=82). The 30-day mortality and stroke rate was 0.4%. In 132 patients (54%), extubation occurred within the first 6 h after surgical treatment. The median hospital stay was 7 days with 48% (n=107) of patients discharged home without need for any cardiac rehabilitation.

Conclusions: Minimally invasive thoracic aortic surgery can be performed successfully at specialized cardiac surgery centers. Preoperative careful and accurate analysis of patient's computed tomography scan is essential to promote patient-tailored planning and promote optimal surgical exposure.

【微创胸主动脉手术:我们的经验】。
背景:微创技术的经验日益丰富,加上突出的治疗效果和通过胸椎切开术暴露整个胸近端主动脉的良好手术表现,促使外科医生将这种方法应用于更具挑战性的手术,如主动脉根部和弓的治疗。方法:2016年9月至2024年4月,243例患者在意大利安科纳-马尔凯理工大学Lancisi心血管中心心脏外科连续接受近端主动脉切口手术治疗。所有病例术前均行计算机断层扫描。结果:患者平均年龄65±12岁,男性176例(72%)。主动脉瓣病变发生率为66.9% (n=85),分别有127例(52%)和44例(18%)患者出现明显的主动脉瓣返流或狭窄。29%的患者发现双尖瓣主动脉瓣(n=70)。手术方法包括使用Bentall (n=64)或David (n=24)技术的主动脉根部手术(n=88)、孤立的升主动脉置换术(n=73)和联合治疗:升主动脉和主动脉瓣置换术(n=82)。30天死亡率和中风率为0.4%。132例(54%)患者在手术治疗后6小时内拔管。中位住院时间为7天,48% (n=107)的患者出院回家时不需要任何心脏康复。结论:微创胸主动脉手术可以在专门的心脏外科中心成功进行。术前仔细和准确地分析患者的计算机断层扫描对于促进患者量身定制的计划和促进最佳手术暴露是必不可少的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Giornale italiano di cardiologia
Giornale italiano di cardiologia CARDIAC & CARDIOVASCULAR SYSTEMS-
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