自体心包微创主动脉瓣新瓣置换术的首次经验

R. Komarov, A. M. Ismailbev, O. O. Ognev, A. N. Dzyundzya, A. Danachev, M. Saliba, M. Lenkovets
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引用次数: 0

摘要

高光。利用自体心包进行微创主动脉瓣新瓣膜置换术是一项困难的任务,因为心包的采集。胸腔镜下心包的切除提供了一个在视觉控制下足够大小的心包贴片。因此,胸腔镜心包采集可以将微创心脏手术的所有优点转移到自体心包主动脉瓣新瓣膜置换术中。与心脏手术的金标准切口-正中胸骨切开术相比,微创主动脉瓣(AV)置换术与手术的创伤性、住院时间、疼痛程度的减少有关,并且提供更快的康复和更好的外观。采用自体心包进行房室新瓣膜置换术是安全的,在中短期随访中具有良好的血流动力学参数。然而,这种技术需要一个大的心包贴片,以形成新的小叶,从而使微创入路的使用复杂化。我们通过引入胸腔镜心包切除术来解决这个问题。我们报告两例成功的微创房室新瓣膜置换术,采用胸腔镜下外周体外循环的自体心包。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Minimally invasive aortic valve neocuspidization using autologous pericardium – first experience
Highlights. Conducting minimally invasive aortic valve neocuspidization using autologous pericardium is a difficult task due to pericardial harvesting. Thoracoscopic harvesting of the pericardium provides a pericardial patch of sufficient size under visual control. Thus, thoracoscopic pericardial harvesting can transfer all advantages of minimally invasive cardiac surgery to aortic valve neocuspidization using autologous pericardium.Abstract. Minimally invasive aortic valve (AV) replacement is associated with a decrease in the traumatic nature of the procedure, the length of hospital stay, severity of pain, and provides faster rehabilitation and better cosmetic look compared to the gold standard incision in cardiac surgery –median sternotomy. AV neocuspidization using autologous pericardium is safe, associated with excellent hemodynamic parameters in short- and medium-term follow up. However, this technique requires a large pericardial patch to later form new leaflets, thus complicating the use of minimally invasive approach with this type of intervention. We have addressed this issue by introducing thoracoscopic pericardial harvesting. We report two successful cases of minimally invasive AV neocuspidization using autologous pericardium harvested through a thoracoscopic approach with peripheral cardiopulmonary bypass.
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