全胸腔镜下二尖瓣置换的体外循环管理

摘要

目的 总结全胸腔镜下二尖瓣置换手术的体外循环的管理方法.方法 85例二尖瓣病变患者,采用全胸腔镜下二尖瓣置换术,对体外循环建立方法、体外循环管理及手术后结果进行评价.结果 85例患者体外循环时间为90～155(120.7±17.4) min,升主动脉阻断时间40～90(51.2±9.1)min.所有患者手术过程顺利.术后均恢复良好,无严重并发症.结论 全胸腔镜下二尖瓣置换术的体外循环方法安全、可行.%Objective To summarize the management of cardiopulmonary bypass ( CPB ) in patients undergoing mitral valve replacement surgery with total video thoracoscope. Methods Eighty - five consecutive patients with mitral valve diseases undergoing mitral valve replacement surgery with total video thoracoscope were included. The methods of CPB setup and the precise management during surgery and the clinical results were evaluated. Results The CPB time of the patients was 90 - 155 ( 120.7 ± 17. 4 ) min and the aortic - clamping time was 40- 90(51.2±9.1 ) min. One patient had bleeding due to aortic purse string loose after CPB disconnection, which resulted in unstable hemodynamics and necessitated urgent treatment, then recovered uneventfully. All other patients recovered well without any severe complications. Conclusion The cardiopulmonary bypass of mitral valve replacement surgery with total vedio thoracoscope is safe and practical.