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首页> 外文期刊>Journal of cardiac surgery. >The micro-mitral operation comparing the Port-Access technique and the transthoracic clamp technique.
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The micro-mitral operation comparing the Port-Access technique and the transthoracic clamp technique.

机译：微端口操作比较了Port-Access技术和经胸钳技术。

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BACKGROUND: Several minimally invasive approaches to the mitral valve have been described, including parasternal incision and right anterolateral thoracotomy. MATERIAL AND METHODS: Since September 1996, 58 patients underwent minimally invasive mitral valve surgery at our institution through a right anterolateral minithoractomy. Two different techniques were used for institution of cardiopulmonary bypass (CPB) and aortic clamping: in the Port-Access group (group A) patients had femoro-femoral cannulation with a special arterial cannula to introduce an endoaortic balloon clamp (n = 23). The second group (group B) of patients underwent femoro-femoral CPB as well in combination with a specially designed transthoracic aortic clamp (Chitwood technique, n = 35). Patients were assigned to either technique in a nonrandomized fashion. Demographics were similar in both groups. RESULTS: In group A, 4 valves were replaced, 19 patients had mitral valve repair. In group B, 7 patients had valve replacement and 28 patients underwent mitral repair. Four patients in group A were converted to Chitwood technique due to endoclamp dysfunction. Operating time, CPB time, cross-clamp time, and postoperative blood loss were lower in group B (operating time 295 +/- 83 min vs. 236 +/- 63.9 min; CPB min 167.6 = 64.9 min vs. 137.6 +/- 38.2 min; cross-clamp time 105.9 +/- 51.7 min vs. 78.9 +/- 25.2 min; postoperative blood loss 584 +/- 428 mL vs. 323 +/- 209 mL [p < 0.05]). Clinical outcome regarding postoperative mechanical ventilatilation time, hospital stay and hospital mortality was not different between groups. CONCLUSIONS: Minimally invasive mitral valve procedures via right anterolateral minithoracotomy, including complex valve repair, can be performed successfully using either technique. However, the Chitwood technique provides better intraoperative handling with shorter operation time and less postoperative blood loss. Additionally, costs of a procedure are less using the Chitwood technique compared to the Port-Access technique.
机译：背景：已经描述了对二尖瓣的几种微创方法，包括胸骨旁切口和右前外侧胸廓切开术。材料与方法：自1996年9月以来，本院通过右前外侧微开孔术对58例患者进行了微创二尖瓣手术。两种不同的技术被用于进行体外循环（CPB）和主动脉钳夹术：在Port-Access组（A组）中，患者使用了带有特殊动脉套管的股股动脉套管，以引入主动脉内气囊钳（n = 23）。第二组（B组）患者也接受了股-股CPB联合特殊设计的经胸主动脉夹钳（Chitwood技术，n = 35）。患者以非随机方式分配给任何一种技术。两组的人口统计学特征相似。结果：在A组中，更换了4个瓣膜，其中19例二尖瓣修复。 B组中有7例患者进行了瓣膜置换术，其中28例接受了二尖瓣修复。由于内闭功能障碍，A组中的4例患者转换为Chitwood技术。 B组的手术时间，CPB时间，交叉钳夹时间和术后失血量较低（手术时间295 +/- 83分钟vs.236 +/- 63.9分钟; CPB分钟167.6 = 64.9分钟vs.137.6 +/- 38.2分钟;交叉钳位时间105.9 +/- 51.7分钟vs. 78.9 +/- 25.2 min;术后失血584 +/- 428 mL和323 +/- 209 mL [p <0.05]）。两组之间有关术后机械通气时间，住院时间和住院死亡率的临床结果无差异。结论：通过右前外侧小切口切开术进行的微创二尖瓣手术，包括复杂的瓣膜修复，均可使用上述两种方法成功进行。但是，Chitwood技术可提供更好的术中操作，缩短手术时间，减少术后失血量。另外，与Port-Access技术相比，使用Chitwood技术的过程成本更低。

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