■用于主动脉瓣置换术(AVR)的右前微型开胸手术(RAMT)是一种避免胸骨切开术的微创手术。在这里,我们报告了通过RAMT方法进行AVR重做心脏手术的患者的结局.
本病例系列报告了14次连续重做手术的临床结果,2020年至2023年在卡尔加里(加拿大)和格但斯克(波兰)完成。主要结果是30天死亡率和致残性中风。次要结果包括手术时间,血流动力学,永久性起搏器植入术(PPM),ICU的长度和住院时间,新的术后心房颤动(POAF),术后输血,急性呼吸窘迫综合征(ARDS)的发病率,连续性肾脏替代治疗(CRRT)和/或透析的比率,和胸管输出在手术后的前12小时。
■9名患者为男性,平均年龄为64.36岁。没有死亡,而一名患者术后出现致残性中风。平均体外循环和交叉钳夹时间为136分钟和90分钟,分别。三个病人需要PPM,3名患者需要输血,2开发了新的POAF。ICU和住院时间的中位数分别为2天和12天,分别。瓣膜旁漏的发生率没有超过痕量,平均跨瓣膜平均梯度为12.23mmHg。
■需要redo-AVR的患者数量正在增加。对于许多患者来说,重新胸骨切开术可能不可行。这项研究表明,对于需要AVR的患者,RAMT方法是重做胸骨切开术的安全替代方法。
UNASSIGNED: Right anterior mini thoracotomy (RAMT) for aortic valve replacement (AVR) is a minimally invasive procedure that avoids sternotomy. Herein, we report the outcomes of patients who underwent redo-cardiac via a RAMT approach for AVR.
UNASSIGNED: This case series reports the clinical outcomes of 14 consecutive redo operations, done in Calgary (Canada) and Gdansk (Poland) between 2020 and 2023. Primary outcomes were 30-day mortality and disabling stroke. Secondary outcomes included surgical times, hemodynamics, permanent pacemaker implantation (PPM), length of ICU and hospital stay, new post-operative atrial fibrillation (POAF), post-operative blood transfusion, incidence of acute respiratory distress syndrome (ARDS), rate of continuous renal replacement therapy (CRRT) and/or dialysis, and chest tube output in the first 12-hours after surgery.
UNASSIGNED: Nine patients were male, and the mean age was 64.36 years. There were no deaths, while one patient had a disabling stroke postoperatively. Mean cardiopulmonary bypass and cross clamp-times were 136 min and 90 min, respectively. Three patients needed a PPM, 3 patients needed blood transfusions, and 2 developed new onset POAF. Median lengths of ICU and hospital stays were 2 and 12 days, respectively. There was no incidence of paravalvular leak greater than trace and the average transvalvular mean gradient was 12.23 mmHg.
UNASSIGNED: The number of patients requiring redo-AVR is increasing. Redo-sternotomy may not be feasible for many patients. This study suggests that the RAMT approach is a safe alternative to redo-sternotomy for patients that require an AVR.