CAJ | 학술논문

目的评价一站式杂交技术治疗成人复杂性心脏病的疗效及安全性.方法 2011年11月至2012年3月,入选5例成人复杂性心脏病患者接受一站式杂交手术治疗.其中,男性4例,女性l例；年龄(58.8±14.7)岁；冠状动脉多支病变2例,冠心病合并瓣膜病2例,动脉导管未闭合并瓣膜病l例.手术在一站式杂交手术室进行,经胸部肋间小切口施行微创心脏手术(左前降支冠状动脉旁路移植术或瓣膜手术),并同期行介入治疗.术后分析其疗效及安全性.结果 5例患者均顺利行一站式杂交手术,即刻冠状动脉造影显示左乳内动脉桥均通畅.共有6处非左前降支病变接受经皮冠状动脉介入治疗(置入药物洗脱支架6枚).围手术期未发生死亡、心肌梗死、心力衰竭、瓣膜相关并发症、呼吸衰竭、卒中和二次手术.平均随访3.2(1 ～5)个月,所有患者均存活,无心绞痛、人工瓣膜障碍及动脉导管再通病例.结论一站式杂交技术治疗成人复杂性心脏病能减少手术创伤,降低手术复杂性,且安全、有效.
목적 평개일참식잡교기술치료성인복잡성심장병적료효급안전성.방법 2011년11월지2012년3월,입선5례성인복잡성심장병환자접수일참식잡교수술치료.기중,남성4례,녀성l례；년령(58.8±14.7)세；관상동맥다지병변2례,관심병합병판막병2례,동맥도관미폐합병판막병l례.수술재일참식잡교수술실진행,경흉부륵간소절구시행미창심장수술(좌전강지관상동맥방로이식술혹판막수술),병동기행개입치료.술후분석기료효급안전성.결과 5례환자균순리행일참식잡교수술,즉각관상동맥조영현시좌유내동맥교균통창.공유6처비좌전강지병변접수경피관상동맥개입치료(치입약물세탈지가6매).위수술기미발생사망、심기경사、심력쇠갈、판막상관병발증、호흡쇠갈、졸중화이차수술.평균수방3.2(1 ～5)개월,소유환자균존활,무심교통、인공판막장애급동맥도관재통병례.결론 일참식잡교기술치료성인복잡성심장병능감소수술창상,강저수술복잡성,차안전、유효.
Objective To evaluate the efficacy and security of one-stop hybrid cardiac surgery for the treatment of adult patients with complex heart disease.Methods From November 2011 to March 2012,a total of 5 patients [4 male,mean age:(58.8 ± 14.7)years] underwent one-stop hybrid approach in the hybrid operating room.Two patients suffered from multi-coronary lesions,2 patients were diagnosed with both valvular heart disease and coronary disease,and another 1 patient had valve disease and congenital heart disease (patent ductus arteriosus).Minimally invasive cardiac surgery(coronary artery bypass grafting for the left anterior descending or valvular surgery) and percutaneous intervention were performed in an enhanced operative unit.The efficacy and security of one-stop hybrid cardiac surgery were evaluated after the procedure.Results The one-stop hybrid procedure was successful in all patients.Left internal mammary artery grafts were unobstructed.A total of 6 non-left anterior descending coronary lesions were treated by percutaneous coronary intervention and 6 drug-eluting stents were implanted.There was no death,perioperative myocardial infarction,heart failure,prosthetic valve dysfunction,respiratory failure,stroke or repeat surgery during the procedure period.All patients remained free from angina,prosthetic valve dysfunction and patent ductus arteriosus recanalisation during the 3.2 months (rang 1 to 5 months) follow-up period.Conclusion One-stop hybrid cardiac surgery provides a reasonable,feasible and safe alternative for treating adult patients with complex heart disease.