经胸小切口封堵术治疗粗大动脉导管未闭

经胸小切口封堵术治疗粗大动脉导管未闭

刘瑞生邢旺孙伟杨大鹏李元敏宋兵

（医院心血管外科，兰州）

目的：探讨经胸小切口封堵术治疗粗大动脉导管未闭（patentductusarteriosus，PDA）的临床效果。方法：年3月~年12月，对13例直径≥10mm的动脉导管未闭患者行经胸小切口封堵术，经左侧胸骨旁第2肋间2~3cm切口进胸，在食道超声引导下，用PDA封堵器行动脉导管封堵术。结果：全组均封堵成功，无死亡，无术后封堵器脱落，无左肺动脉狭窄。手术时间（48.7±8.5）min，术后（4.9±2.3）h脱离呼吸机，（9.3±1.9）d出院，术中、术后均未输血，无溶血发生。随访3~9个月，平均6个月，未见封堵伞移位，无残余漏、心内膜炎。结论:经胸小切口封堵术具有操作简单、微创、术后恢复快、疗效满意等特点，是治疗粗大动脉导管未闭的理想方法。

经胸小切口;封堵术;动脉导管未闭

TransthoracicMinimallyInvasiveOcclusionforLargePatentDuctusArteriosusLiuRuisheng,XingWang,SunWei,etal.DepartmentofCardiovascularSurgery,FirstHospitalofLanzhouUniversity,Lanzhou,China

ObjectiveToanalysistheclinicaleffectoftransthoracicminimallyinvasiveclosureforlargepatentductusarteriosus.MethodsFromMarchtoDecember,13casesofpatentductusarteriosus(PDA)withadiameter≥10mmreceivedtransthoracicminimallyinvasiveocclusionundertrans-esophagealultrasoundguidance.Theoperationwasperformedviaaleftparasternalincision(length,2-3cm)throughthesecondintercostalunderthegeneralanesthesia.ResultsAllthepatientsweresuccessfullyoccluded.Nodeathoroccluderdetachmentoccurredafteroperation.Themeanoperationtimewas(48.7±8.5)min,themechanicalventilationtimewas(4.9±2.3)hoursafteroperation,andthedurationofhospitalstaywas(9.3±1.9)days.Duringtheoperationandpostoperation,nobloodtransfusionwasrequiredandnohemolysisoccurred.Duringthefollow-upvisitsfor3-9months(mean,6months),nooccluderdislocation,leakageorendocarditisoccurred.ConclusionThetransthoracicminimallyinvasiveocclusionforlargepatentductusarteriosusissimple,minimallyinvasive,effectiveandconvenient.

Transthoracicminimallyinvasive;Occlusion;Patentductusarteriosus

中国微创外科杂志

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