Analysis Of Clinical Efficacy Of Single Utility Port Video-assisted Thoracoscopy Beating Heart In The Treatment Of Atrial Septal Defect

Objective: To compare and analyze the clinical research data of atrial septal defect repair with single utility port video-assisted thoracoscopy beating heart surgery and conventional thoracotomy incision cardioplegia surgery,and evaluate the single utility port video-assisted thoracoscopy beating heart defect the feasibility of repair surgery,and analyze the pros and cons of the two groups of surgical methods.Methods: From September 2015 to December 2018,52 patients with congenital heart malformations diagnosed as atrial septal defect who were diagnosed at the cardiac surgery center of The First Affiliated Hospital of Bengbu Medical College were selected.They underwent single utility port video-assisted thoracoscopic atrial septal defect repair or conventional thoracomedian incision atrial septal defect repair.According to the surgical method,they were divided into two groups: observation group(single utility port video-assisted thoracoscopy with beating heart surgery group)25 cases,aged(36.36 ± 15.60)years old,weight(55.28 ± 11.78)kg,color Doppler ultrasound showed long atrial septal defect Diameter(29.32 ± 5.21)mm;27 patients in the control group(conventional thoracotomy incision cardioplegia surgery group),aged(36.17 ± 19.89)years old,weight(50.11 ± 17.23)Kg,and the color Doppler ultrasound suggested the long diameter of atrial septal defect(28.52)± 8.69)mm.Intraoperative monitoring indicators were statistically calculated for the two groups of patients: operation time(min),CPB time(min),aortic block time(min),superior and inferior vena cava block time(min),and intraoperative blood transfusion volume(ml)Postoperative observation indicators include: ventilator assist time(h),postoperative drainage volume(ml),ICU time(h),postoperative hospital stay(d),hospital stay(d),and perioperative complications.Statistical analysis was performed using chi-square test and t-test.Results: The operation was successfully completed in both groups.Compared with the control group,the observation group in the ventilator assist time [(10.80 ± 4.70)h ratio(14.28 ± 6.13)h,t = 2.282,P = 0.027],the ICU time [[28.19 ± 9.15] h ratio(46.54 ± 21.51)h,t = 4.053,P = 0.000],intraoperative blood transfusion volume [(216.00 ± 172.43)ml ratio(366.67 ± 227.02)ml,t = 2.679,P = 0.010],postoperative 24-hour drainage [(146.32 ± 157.78)ml ratio(315.37 ± 251.87)ml,t = 2.893,P = 0.006],hospital stays [(14.84 ± 3.33)d ratio(19.48 ± 7.46)d,t =2.933,P = 0.006],the difference is statistically significant(P <0.05);the two groups of patients have differences in surgical time,extracorporeal circulation time,complications,etc.(P> 0.05),without statistical significance.All patients were followed up on an outpatient or telephone basis.There were no other serious complications such as residual leakage and death.The follow-up results were satisfactory.Conclusion: Single utility port video-assisted thoracoscopy beating heart repair of atrial septal defect is safe and feasible.It not only achieves the effect of traditional surgery,but also has less trauma and quick recovery,and it is worthy of popularization and application.