胸骨下段小切口行先天性心脏病矫治术116 例.PDF

206 Chinese Cir culatio n Jo ur nal, A ug. 2000, V ol. 15 N o . 4( Serial N o . 104) 116 李守军　吴清玉　吕　锋　沈向东　苏俊武　王小启　刘永民　凤　伟 : : ( 5. 7 6. 8) , :1 : ,, 66 , 33 , 1 , 13 , , 116 , 3 50 Li mited Lower Sternotomy for Correction in Congenital Heart Diseases L i Shoujun, W u Qingy u, L u F eng, et al. Depar tment of Car diac Sur g ery , Car dio vascular Instit ute a nd Fu W ai Hospital, CA M S and PU M C, Beijing ( 100037) Abstract O bject ive : T o rev iew the ex per iences o f cor rection for congenital hear t defect thro ugh limit ed low er ster noto my . M etho ds: Bet ween Aug ust 1998 and A ugust 1999, 116 cases o f cong enital hear t diseases under went limited lo wer sterno tomy for cor rection. T he age r anged fro m 3 mo nths to 50 y ears w ith a mean o f 5. 7 6. 8 y ears. A 5 7 cm in the childr en o r 9 11 cm in adult midline incision w as made fro m the third rib to t he base o f xipho id pr ocess. Cardio pulmonar y bypass was established as usual. Abnor malities included ventr icular sept al defect in 66 cases, atr ial sepal defect in 33, t etralo gy of Fallot in 13, pulmonar y atr esia, endocar dial cushio ns defect, pulmo na ry stenosis and unr oo fed co ro nary sinus syndro m in 1 case, r espectively. R esults: T her e w ere neither per io per ativ e com plications nor hospital death. A or tic cr oss-clamp tim e, Cardio pulmonar y by pass ( CP B) time, and posto per ative av era ge mechanical ventilat ion t ime w as 34. 7 minut es, 61. 6 minutes, and 16. 1 ho urs, r espectv ely. T he median bloo d loss 116. 4 ml( r ange, 23 t o 590 ml) and t he incision was 8. 2 cm ( r ange, 5 to 11 cm) . Conclusio n: L imit ed low er st ernot omy is a safe alt ernativ e for cor rection of co genita l hear t defect . It is cosmetically acceptable and less t raumatic. Key words Co ng enital heart defect; Co rr ectio n; M inimally invasiv e ( Chinese Cir culatio n Jo ur nal, 2000, 15: 206. ) , , [ 1 4] , 8 11 6 , , : ( VSD) 66 , 32 , ( ASD) 4 , ,, ( P DA ) 3 ( M I) 3 ; ASD 1998