Minimally invasive open-heart surgery in beating heart under cardiopulmonary bypass and light hypothermia / 中国综合临床

ABSTRACT

Objective To evaluate the minimally invasive techniques and myocardial protective results of open heart surgery in beating heart.Methods 138 patients underwent minimally invasive open heart surgery in beating heart under cardiopulmonary bypass (CPB) with light hypothermia,of which 58 cases underwent right anterolateral thoracotomy,35 cases had lower sternotomy and full length sternotomy was performed in 45 cases.Among 138 cases,97 cases had repairment of atrial and ventricular septal defects,8 atrioventricularis communis,18 other congenital heart disease,two left atrial myxomas,one mitral valvuloplasty and 12 mitral value replacement.Results There were no severe arrhythmia and air embolism,but only one operative death because of low cardiac output.Other patients were discharged and had no late deaths.Conclusion Minimally invasive open heart operation in beating heart is a feasible,safe and effective technique for most of the cardiac surgery.Advantages of a right anterolateral thoracotomy or lower hemisternotomy in beating heart are obvious,including a smaller incision,less injury and blood loss,quick recovery,maintenance of the integrity of the bony cage and excellent myocardial protection.It is consistent with the idea of minimally invasive surgery.