Study Of Surgical Treatment To Patients With Congenital Heart Disease Under The Totally Thoracoscope And Effect Of Quality Of Life In Patients

PartⅠEfficacy of Totally Thoracoscopic Surgery to Complex Congenital Heart DiseasesAIM:To explore the feasibility and efficacy of surgical treatment to patients with complex congenital heart disease(CCHD)under the totally thoracoscopic surgery (TTS).METHODS:From Dec 2007 to Apr 2009,13 patients(7male,6female) who suffered complex congenital heart diseases underwent totally thoracoscopic surgery using a minimally invasive approach.The mean age was 14.5±8.2years (6~34years),the mean weight 34.5±12.6kg(17.5～52.0kg).They were compared to the patients who underwent operations via a full median sternotomy(MS group)in the corresponding period.RESULTS:All patients were performed successfully without any complications.The mean cardiopulmonary bypass time (160.0±26.0 minutes)in the TTS group was longer the MS group(mean 106.8±22.4,p＜0.05),the mean cross-clamp times(102.1±23.8min)in the TTS group longer the MS group(mean 63.7±17.9min,p＜0.05),the length of intensive care unit stay(26.4±11.4hours)in the TTS group shorter than the MS group (mean 125.3±144.5 hours,p＜0.05).The mean drainage of pleura cavity and postoperative hospital stay were similar in both groups(p＞0.05).CONCLUSIONS:Totally thoracoscopic surgery can be performed safely in patients with complex congenital heart diseases.PartⅡHybridization Technique of Interventional Therapy and TotallyThoracoscopic Surgery to Complex Congenital Heart DiseasesAIM:To explore the effect of treatment of hybridization technique to patients with complex congenital heart disease(CHD).METHODS:A patient with complex congenital heart diseases of Atrial Septal Defects(ASD),partial anomalous pulmonary venous connection,Patent Ductus Arteriosus(PDA)is treated with hybridization technique of interventional therapy and totally thoracoscopic surgery(TTS)by stages.RESULTS:Diseases was cured. Echocardiography indicates that the occluder is placed successfully and there is no shunt between atriums after six months.CONCLUSION:Hybrid is a developing technique in minimally invasive cardiac surgery.PartⅢEffect of Quality of Life in Patients between through Totally Thoracoscopic Surgery and Median SternotomyAIM:To compare the effect on the psychologic status of patients with congenital heart diseases between totally thoracoscopic surgery and median sternotomy.METHODS:30 patients from TTS cases and 33 patients from MS cases at the same time were studied from Dec 2007 to May 2008.Symptoms Checklist (SCL-90)was applied to all the patients to compare and analysis their psychological status 1 week after operation.RESULTS:The levels of somatization,anxiety,depression,diet and sleep in patients from TTS were significantly higher than patients from MS(p＜0.05).Gender,age and education were correlated with the psychologic status of patients after operation.CONCLUSION:The psychologic status of patients from TTS 1 week after operation were significantly better than that of patients from MS.