PHẪU THUẬT xâm lấn tối THIỂU TRÊN BỆNH NHÂN TIM bẩm SINH

PHU THUT XÂM LN TI THIU TRÊN BNH NHÂN TIM BM SINH


Phạm Thế Việt, Nguyễn Hoàng Định
-
Bnh vin Hoàn M Sài Gòn Premium, thành ph H Chí Minh

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
-8 cm, thay vì 12-
Có nhi
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


 


 

 

TLN: th


SUMMARY
MINIMALLY INVASIVE APPROACH TO CONGENITAL HEART LESIONS
(Limited lower sternotomy incision)
Minimally invasive heart surgery (also called keyhole surgery) is performed through small
incisions, sometimes using specialized surgical instruments. The incision used for minimally

invasive heart surgery is about 6 to 10 cm instead of the 12 to 20 cm incision required for
traditional surgery.
There are many Surgical Approaches to the Mediastinum:
 Anterolateral thoracotomy
 Parasternal
 Axillary
 Limited sternotomy (upper vs lower)
But we choose limited lower sternotomy inscision to congenital heart lesions such as ASD
os, ASD-TV regurgitation, VSD, PAPVR and MV regurgitation. We choose this technique because
we can approach the lesion, need only one incision, the special equipment is not complex and the
cost is cheap.

 Minimal Access Limited Sternotomy

Potential Benefits: Cosmetic*, Psychological, Less Discomfort, Limit ICU/Hospital Stay,
Faster Convalescence
ASD: atrial septal defect; VSD: ventricular septal defect; TV: tricuspid valve; MV: mitral
valve; PAPVR: partial anomalous pulmonary venous return; CHD: Congenital Heart Disease.


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
1.2).





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

ng, siêu âm tim theo dõi.






ASD
5

1

4


4  

14  60 kg

25  51 min

19  43 min












1. Cohn LII (1998), Parastcrnal approach for minimally invasive aortic valve surgery. Oper
Tech Card Thorac Surg, 3:54-61
2. Gundry SR, Shattuck OII, Razzouk AJ, et ah (1998), Facile minimally invasive cardiac
surgery via mini-sternotomy. Ann Thorac Surg, 65:1100-1104.
3. Zlotniek A, Giffeather M, Adams DII (1999), Innominate vein cannulation for venous
drainage in nfinimally invasive aortic valve surgery. Ann Thorac Surg 67:861-865.
4. Byrne JG, Aranki SF, Rizzo R J, et ah (1999), Mitral valve surgery after previous CABG
~4th functioning IMA grafts. Ann Thorac Surg, 68:2243-2247.
5. Bichcll DP, Bala~ter JM, Aranki SF, et ah (1997), Axilloaxillary cardiopulmonary
bypass: A practical ahernativc to femoro-fcmoral bypass. Ann Thorac Surg, 61:702-705.
6. Aklog L, Adams DII, Couper GS, et ah (1998), Techniques anti results of direct-access
minimally invasive mitral valve surgery: A paradigm for the future. J Thorac Cardiovasc
Surg, 116:705-715.
7. Dory DB, DiRusso GB, Doty JR (1998), Full-spectrum cardiac surgery through a
minimal incision: Mini-sternotomy (lower halt) technique. Ann Thorac Surg, 65:573-577.
8. Navia JL, Cosgrove DM (1996), Minimally iuvasive mitral valve operations. Ann Thorac
Surg, 65:569-570.
9. Byrne JG, Adams DII, Mitchell ME, et ah (1999), Minimally invasive direct access atrial
septal defect in adults. Am J Cardio, 181:919-922.