PDF(Pubmed)
Abstract：
Anesthesia management of Totally thoracoscopic cardiac surgery (TTCS) has been the subject of much debate and discussion. In this single center retrospective study, we summarize the experience of clinical anesthesia management for TTCS by review the medical records of our medical center and look forward to its future development. In this retrospective study, 103 patients (49 male and 54 female) were enrolled, the mean age was 56.7 ± 14.4 years old. The participants underwent Mitral Valve Replacement (MVR) + Tricuspid Valve Annuloplasty (TVA) (42, 40.8%), Mitral Valve Annuloplasty (MVA) + TVA (38, 36.9%), MVA (21, 20.4%), and MVR (2, 1.9%)，respectively. Intraoperative hypoxemia, radiographic pulmonary infiltrates, and pneumonia were observed in 19 (18.4%), 84 (81.6%), and 13 (12.6%) patients, respectively. The LOS of ICU and POD were as follows: MVR + TVA (55.1 ± 25h, 9.9 ± 3.5 d), MVA + TVA (56.5 ± 28.4h, 9.4 ± 4.2d), MVA (37.9 ± 21.9h, 8.1 ± 2.3d) and MVR (48 ± 4.2h, 7.5 ± 2.1d). No reintubation, reoperations, postoperative cognitive dysfunction, 30-day mortality were observed in the present study. The present study demonstrated that applying this anesthesia management for TTCS associated with acceptable morbidity, intensive care unit and postoperative hospital lengths of stay. The finding from the present study might provide some new approach for Anesthesia management of TTCS.
摘要：
全胸腔镜心脏手术（TTCS）的麻醉管理一直是许多争论和讨论的主题。在这项单中心回顾性研究中，我们通过回顾我院医疗中心的病历，总结了TTCS的临床麻醉管理经验，并对其未来的发展进行了展望。在这项回顾性研究中,103名患者（男性49名，女性54名）入选，平均年龄为56.7±14.4岁。参与者接受了二尖瓣置换术（MVR）+三尖瓣成形术（TVA）（42，40.8％），二尖瓣瓣膜成形术（MVA）+TVA（38，36.9%），MVA（21，20.4%），和MVR（2，1.9%），分别。术中低氧血症,放射学肺浸润，19例(18.4%)出现肺炎，84（81.6%），13名(12.6%)患者，分别。ICU和POD的LOS如下:MVR+TVA(55.1±25h,9.9±3.5d)，MVA+TVA(56.5±28.4h,9.4±4.2d)，MVA(37.9±21.9h,8.1±2.3d)和MVR(48±4.2h,7.5±2.1d)。没有再插管,重新操作,术后认知功能障碍,在本研究中观察到30天的死亡率。本研究表明，将这种麻醉管理应用于与可接受的发病率相关的TTCS，重症监护病房和术后住院时间。本研究的发现可能为TTCS的麻醉管理提供一些新的方法。
