ABSTRACT
Objective To discuss the effectiveness of heart operation through subaxillary minithoracotomy.Methods Subaxillary minithoracotomy heart operation was carried out in 378 cases between March 1995 and October 2004.The operation was performed under beating heart and without the occlusion of the ascending aorta in 81 cases of atrial septal defect, 32 cases of ventricular septal defect,and 16 cases of other diseases.The operation was completed under low temperature and extracorporeal circulation in other 249 cases.Results The operation was accomplished smoothly in all the cases.The operation time was 167?2.0 min,and the extracorporeal circulation time was 28.1?16.6 min.Postoperatively,1 patient with double-chamber anormaly of the right ventricle was given a tracheotomy because of an acute laryngeal edema,1 patient with tetralogy of Fallot died of low cardiac output syndrome,1 patient had a cerebral embolism,2 patients experienced an incision fat liquefaction,and the remaining patients recovered uneventfully.A follow-up for 2 months ~ 10 years(mean,5.1 years) in 366 patients revealed a full range of physical activities.One case of ventricular septal defect with residual shunt and 1 case of cerebral embolism were fully recovered.Conclusions Subaxillary minithoracotomy open heart operation has advantages of minimal invasion,quick recovery,simplicity of performance,and good cosmetic results.
ABSTRACT
Objective To summarize the surgical treatment of heart disease in patients aged 70 years and over. Methods From May 1995 to July 2000, 23 patients aged 70 years and over underwent cardiac operation at our department. Thirteen cases underwent isolated coronary bypass grafting, 5 had isolated valve operations , 3 had combined valve operation and coronary bypass grafting, 1 had excision of left atrial myxomas, 1 had combined pericardiectomy and coronary bypass grafting .Results Postoperative complications occurred in 5 cases (21.7%). The hospital mortality rate was 4.3% (1 case) . All of the 22 cases survived showed improvements in cardiac function and quality of life during a follow up of 1 month to 5 years.Conclusions Cardiac operations can be performed in patient saged 70 yeas and over with a satisfactory outcome,earlier referral and intervention is mandatory to improve results in this patients.