Objective: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median stemotomy through right atrium in treatment of common congenital heart diseases. Methods:...Objective: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median stemotomy through right atrium in treatment of common congenital heart diseases. Methods: Clinical data of 59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy from May, 2011 to February, 2013 and 77 cases of same diseases with traditional median stemotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect. The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis. Results: No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding. No significant differences were in CPB time and postoperative ventilator time between groups (P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median stemotomy, with statistically significant differences (P<0.05). In six month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in 8 patients in the traditional median sternotomy group (traditional group), whereas patients in another group were well recovered. Conclusions: Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median stemotomy, without the increasing incidence of postoperative complications. Additionally, compared with traditional median stemotomy, minimally - invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative recovery.展开更多
Two methods were employed in the management of 18 patients with mediastinal infec-tions after open-heart surgery in a 10-year-period from 1980 to 1989.The first 3 cases weretreated with local debridement and drainage ...Two methods were employed in the management of 18 patients with mediastinal infec-tions after open-heart surgery in a 10-year-period from 1980 to 1989.The first 3 cases weretreated with local debridement and drainage of the involved areas.Of them,1 was cured and 2 de-veloped chronic osteomyelitis of the sternum with an average hospitalization of 91 d.The other 15cases were treated with radical debridement and closed retrosternal irrigation of antibiotic solutions.Fourteen out of the 15 cases were successfully cured with an average hospitalization of 15d and 1case suffered from a recurrence of infection.No hospital mortality occurred in this series and 2 latedeaths were not related to mediastinal infections.It is believed by the authors that radicaldebridement in association with retrosternal irrigation is a far much better method than localdebridement combined with drainage in the management of mediastinal infections afteropen-heart surgery.展开更多
Cardiac surgery is a very common operation nowadays all over the world.Median sternotomy is a routine procedure required for cardiac access during open heart surgery.The complications of this procedure after the cardi...Cardiac surgery is a very common operation nowadays all over the world.Median sternotomy is a routine procedure required for cardiac access during open heart surgery.The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases,and bear a high mortality rate if they occur.Every individual surgeon must pay great attention on every detail during the sternal closure.This article shows the details as to conventional information and updated progress on median sternotomy closure.The update contents involve in biomechanics,number of wires twists,biomaterial and so on.According to our experience,we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.展开更多
基金supported by college medical journal clinicalspecial funds(11321587)
文摘Objective: To compare the clinical outcomes of minimally invasive right subaxillary vertical thoracotomy and traditional median stemotomy through right atrium in treatment of common congenital heart diseases. Methods: Clinical data of 59 cases of common congenital heart diseases treated with minimally invasive right axillary vertical thoracotomy from May, 2011 to February, 2013 and 77 cases of same diseases with traditional median stemotomy in the past three years were retrospectively analyzed, including atrial septal defect, membranous ventricular septal defect and partial endocardial cushion defect. The results were compared from the two groups, including the time for operation and cardiopulmonary bypass, amount of blood transfusion, postoperative drainage, ventilation time, hospital stay, and prognosis. Results: No severe complications happened in both groups, like deaths or secondary surgery caused by bleeding. No significant differences were in CPB time and postoperative ventilator time between groups (P>0.05), while for all of the operative time, the length of incision, postoperative drainage and hospital stay, minimally invasive right axillary vertical thoracotomy was superior to median stemotomy, with statistically significant differences (P<0.05). In six month followup after operation, no complications of residual deformity and pericardial effusion were found in both groups by doing echocardiography, but mild pectus carinatum was found in 8 patients in the traditional median sternotomy group (traditional group), whereas patients in another group were well recovered. Conclusions: Minimally invasive right subaxillary vertical thoracotomy for common congenital heart diseases is as safe as traditional median stemotomy, without the increasing incidence of postoperative complications. Additionally, compared with traditional median stemotomy, minimally - invasive right subaxillary vertical thoracotomy is better in the aspects of hidden incision, appearance, and postoperative recovery.
文摘Two methods were employed in the management of 18 patients with mediastinal infec-tions after open-heart surgery in a 10-year-period from 1980 to 1989.The first 3 cases weretreated with local debridement and drainage of the involved areas.Of them,1 was cured and 2 de-veloped chronic osteomyelitis of the sternum with an average hospitalization of 91 d.The other 15cases were treated with radical debridement and closed retrosternal irrigation of antibiotic solutions.Fourteen out of the 15 cases were successfully cured with an average hospitalization of 15d and 1case suffered from a recurrence of infection.No hospital mortality occurred in this series and 2 latedeaths were not related to mediastinal infections.It is believed by the authors that radicaldebridement in association with retrosternal irrigation is a far much better method than localdebridement combined with drainage in the management of mediastinal infections afteropen-heart surgery.
基金Supported by the National Natural Science Foundation of China(30870620)
文摘Cardiac surgery is a very common operation nowadays all over the world.Median sternotomy is a routine procedure required for cardiac access during open heart surgery.The complications of this procedure after the cardiac surgery range from 0.7% to 1.5% of all cases,and bear a high mortality rate if they occur.Every individual surgeon must pay great attention on every detail during the sternal closure.This article shows the details as to conventional information and updated progress on median sternotomy closure.The update contents involve in biomechanics,number of wires twists,biomaterial and so on.According to our experience,we recommend four peristernal single/double steel wires for sternal closure as our optimal choice.
