JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2016, Vol. 54 ›› Issue (8): 39-43.doi: 10.6040/j.issn.1671-7554.0.2016.351

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A comparative study of total thoracoscopic mitral valve replacement under heart beating and heart arrest

LIU Songtao, SHEN Bin, LIN Hui, LI Xiangwei, WEN Zhaoke   

  1. Department of Thoracic Cardiovascular Surgery, The Peoples Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021, Guangxi, China
  • Received:2016-03-31 Online:2016-08-10 Published:2016-08-10

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Abstract: Objective To compare the efficacy and safety of total thoracoscopic cardiac surgery under heart beating and heart arrest. Methods In the heart beating group(n=19), extracorporeal circulation was established through femoral artery and femoral venous cannula. Mitral valve replacement was implemented under the condition of light hypothermal extracorporeal circulation and aortic cross-clamping on heart beating. In the heart arrest group(n=12), extracorporeal circulation was established through femoral artery and femoral venous cannula. Mitral valve replacement was implemented under the condition of middle hypothermal extracorporeal circulation and aortic cross-clamping with cardial arrest. The clinical parameters of the two groups were compared. Results All operations were successful without low cardiac output syndrome, severe arrhythmia, air embolism, perioperative death, and other serious complications. Heart beating group had longer operation time and aorta blocking time than heart arrest group(P<0.05), but shorter in vitro cycle time, ICU monitoring time, and postoperative hospital stay, and lower medical costs(P<0.05). There were no 山 东 大 学 学 报 (医 学 版)54卷8期 -刘松涛,等.全胸腔镜下心脏不停跳与停跳二尖瓣置换术的对比 \=-statistical differences in CK-MB, LDH and cTnT before operation between the two groups(P>0.05). After in vitro cycle started, the levels of myocardial enzymes increased; CK-MB and cTnT reached the peak value 24 h after operation and then declined, while LDH showed an uptrend. There were statistical differences between the two groups in the levels of enzymes at the same time points(P<0.05). Conclusion Total thoracoscopic mitral valve replacement under heart beating has advantages of quick recovery, lower hospitalization cost, better myocardial protective effect and more patient benefits compared with total thoracoscopic mitral valve replacement under heart arrest. The combination of the two approaches has wide applicative value in clinical practice.

Key words: Efficacy, Total thoracoscope, Heart beating, Mitral valve replacement, Minimally invasive, Safety

CLC Number: 

  • R654.2
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