右胸外侧小切口用于先天性单纯心内畸形矫治术

Correction through a right subaxillary anterolateral minithoracotomy in children with single congenital cardiac defects

摘要:

目的：探讨右胸外侧小切口在小儿先天性单纯心脏畸形心内直视手术中的应用价值。方法：采用该切口体外循环手术２５例，其中继发孔房间隔缺损１３例；室间隔缺损１２例。同期纠正合并畸形右下肺静脉异位引流３例，右流出道狭窄２例。结果：全组手术顺利无死亡。结论：认为这种切口具有损伤小，疤痕小和隐蔽，不引起胸骨鸡胸畸形，美观效果好。除复杂心脏畸形外，可安全有效地替代正中切口矫治某些单纯心脏畸形或可作为传统手术方式的一种补充。

Abstract:

OBJECTIVE: To evaluate the clinical value of a right subaxillary anterolateral minithoracotomy in open heart surgery in children with single congenital cardiac defects. METHODS: Twenty-five cases of children with congenital heart defects were operated through the right subaxillary anterolateral minithoracotomy, with 13 cases of the closure of atrial septal defect (ASD) and 12 cases of the ventricular septal defect (VSD). Accompanied abnormalities (2 cases with right ventricular outflow tract obstruction and 3 cases with partial anomalous pulmonary venous connection) were also corrected at the same time. RESULTS: All the patients were successfully operated. No operative mortality was noted. CONCLUSIONS: Except for complicated cardiac abnormalities, the right subaxillary anterolateral minithoracotomy is a safe and effective alternative to a median sternotomy for the correction of common cardiac defects.This approach is less invasive, produces small and hidden scars with optimal cosmetic appearance, and can avoid the postoperative pigeon breast.