中国体外循环杂志2012，Vol.10Issue(4)：215-217,223,4.
胸腔镜辅助微创心脏手术体外循环管理
Cardiopulmonary bypass management during thoracoscope assisted minimally invasive cardiac surgery: 32 cases reports
李全正 1魏民新 1谭明 1刘宏伟 2李清2
作者信息
- 1. 300052,天津,天津医科大学总医院心血管外科
- 2. 300052,天津,天津医科大学总医院麻醉科
- 折叠
摘要
Abstract
Objective To summarize experiences of extracorporeal circulation ( ECC ) management in thoracoscope assisted minimally invasive cardiac surgery ( TAMICS). Methods Between March 2009 and November 2011 , 32 patients underwent TAM-ICS. ECC cannulas were established through femoral artery and femoral vein ( n = 15 ) or through femoral artery, femoral vein and right internal jugular vein ( n = 15 ) or just through femoral artery and right internal jugular vein ( n =2 ). Vacuum - assisted venous drainage ( VAVD, - 25mmHg ~- 60mmHg ) was implemented during ECC. Myocardial protection was accomplished by blood cardioplegia per-fusion ( n = 12 ), CUSTODIOL HTK solution ( n = 18 ) or by keeping own heartbeat ( n = 2 ). Transesophageal echocardiography ( TEE )was applied in all cases to help heart venting before and after cross - clamping opening. Results All cases had sufficient ECC drainage, ECC time was 86. 1 ±25. 2 min, the aortic cross -clamping time was 48. 2 ± 13. 9 min, 13 cases recovered automatic heart rhythm, ECC assisted time was 30. 5 ± 16. 6min, ultrafiltration volume was 980. 5 ±468. 2 nil, the urine volume was 685. 7 ±316. 5 ml during ECC. All patients discharged. Conclusion ECC cannulation via the femoral vessels is suitable for TAMICS. VAVD techniques can ensure ECC venous drainage sufficiently. The right internal jugular vein catheter used for ECC drainage of superior vena cava is safe and feasible. TEE is very important for surgeon to vent the heart and to understand the heart conditions during TAMICS.关键词
胸腔镜/微创/心外科/体外循环/负压辅助静脉引流/食道超声Key words
Thoracoscope/ Minimally invasive/ Cardiac surgery/ Cardiopulmonary bypass/ Vacuum assisted venous drainage / Transesophageal echocardiography分类
医药卫生引用本文复制引用
李全正,魏民新,谭明,刘宏伟,李清..胸腔镜辅助微创心脏手术体外循环管理[J].中国体外循环杂志,2012,10(4):215-217,223,4.
