微创房间隔缺损闭合术

An 房间隔缺损(ASD) 是先天性心脏缺陷(出生时就存在的问题). ASD患者的房间隔有一个异常的洞, 分隔心脏上两个腔室的墙. As a result, excess blood flows through the right side of the heart and into the lungs, 迫使两个器官更加努力地工作.

自闭症的大小各不相同. Any hole larger than a few millimeters across should be closed to prevent permanent damage to the heart and lungs.

In the past, ASD repair required open-heart surgery through an incision in the center of the chest. These days, we can close ASDs with one of these less invasive procedures:

微创ASD手术闭合. 进入需要维修的区域, your surgeon makes a small "keyhole" incision between two ribs on the right side of your chest.
心导管检查. 用这种侵入性更小的方法, ASD是用导管(薄导管)封闭的, 通过腹股沟血管插入的软管.

心脏外科十大赌博平台排行榜进行锁眼手术, while a type of doctor called an interventional cardiologist performs catheter-based ASD closures. Advantages over open-heart surgery include less post-op pain, a faster recovery and minimal scarring.

Eligibility

Most patients with an ASD are candidates for a minimally invasive approach.

Preparation

Before the procedure, your doctor may order diagnostic tests, such as MRI and CT 扫描，获取你的心脏图像.

我们还会帮你预约加州大学旧金山分校的十大赌博平台排行榜准备项目, where staff will evaluate your medical history and ensure that you're ready to undergo the chosen procedure. 这个预约可能包括一个简短的身体检查, 额外的医学检查, 以及关于麻醉和疼痛控制的讨论.

手术方法:微创手术

Minimally invasive ASD closure usually takes between five and six hours. 你处于全身麻醉状态(完全睡着了). A heart-lung machine is inserted through a small incision in your groin. This supports your organs and allows the surgical team to briefly pause the beating of your heart later in the operation.

Your surgeon starts by making a 4- to 6-centimeter incision on the right side of your chest between two ribs. 一种软手术装置制造方法及图纸, 叫做牵引器, is used to gently separate the ribs to allow insertion of slender surgical instruments. The surgeon then inserts an endoscope – a flexible tube with a 3D camera on the end – to collect detailed images of your heart and the ASD.

Your surgeon accesses the ASD through an opening in the right atrium (one of the heart's two upper chambers). 小的ASD可以缝合. 对于较大的ASD，外科十大赌博平台排行榜用贴片盖住这个洞. The patch can be tissue taken from the pericardium (the sac surrounding the heart) or made from synthetic materials, 如涤纶或特氟龙. 同时把补丁缝到合适的地方, your surgeon temporarily stops your heart from beating and uses the heart-lung machine to keep blood flowing to your organs.

程序:心导管插入术

如果你的自闭症足够小，可以用导管闭合. 而不是在你胸口开个切口, your doctor makes a small incision in the groin and gently guides the catheter through your blood vessels up to the heart. The procedure takes about three hours and may be done under general anesthesia or using sedatives that relax you but allow you to remain conscious.

在手术过程中，你的十大赌博平台排行榜会使用成像技术，比如 X-rays or 超声心动图，引导导管穿过血管. 在测量ASD和检查其他心脏缺陷之后, your doctor feeds a small synthetic patch or closure device through the catheter and into the heart. The patch or device expands to cover the ASD; the catheter is then removed.

Recovery

With the minimally invasive surgery, you spend three to five days recovering in the hospital. 你可能会在重症监护室度过第一个晚上. During your stay, our team closely monitors your condition and watches for signs of infection. 我们会追踪你的血压, breathing and heart rate; manage your pain; and get you up and walking promptly to improve blood flow and speed healing.

如果你通过心导管闭合ASD, you're able to leave the hospital either the same day or the day after.

每个人的治疗方式都不一样, but most patients can return to their regular activities within six to eight weeks. 白天感到疲倦或喘不过气来是很正常的, 你可能会感到胸部疼痛, neck and back.

Follow-up care

在你离开十大赌博平台排行榜之前, we'll provide you with detailed instructions on how to continue recovering at home.

You can rest throughout the day when you feel tired or out of breath, 但是要尽量限制白天小睡的时间. Your goal should be to gradually increase your activity level as you heal. At night, propping yourself up with pillows may make sleep more comfortable.

减轻上半身的酸痛, use the same approach you would for sore muscles: Apply heat and ice alternately, 定期运动和伸展, 根据需要服用止痛药. 如果你腿上有个切口, some swelling is normal; to bring it down, 尽量多走路，坐着的时候抬高双腿.

照顾你的切口

Your incision may be sore, itchy or slightly numb, and may look red or bruised. 这些都是正常的阶段，应该会在几周内消失.

照顾你的切口:

Gently wash the incision with warm water and mild soap, then lightly pat dry with a clean towel.
You can shower, but don't take baths or soak the area until your wounds are completely healed.
The adhesive strips covering your incision should fall off in three to 10 days. 如果没有，在洗澡的时候轻轻地把它们脱掉.

If you have stitches or staples, a medical provider should remove them in 10 to 14 days.

手术后吃什么

滋养你的身体是顺利恢复的关键部分. Even though you may not feel hungry, try to eat small meals throughout the day. 术后饮食应:

低钠饮食. Too much salt can cause swelling and fluid buildup in your limbs and lungs. 不要在食物里加盐.
低脂肪，高瘦肉蛋白.
Include eight glasses of water per day (unless your doctor tells you otherwise).

恢复体力活动

在你手术后的几周内, you can gradually increase your activity level until you're back to normal. Pace yourself, starting with light activity around the house and short walks. 记住以下几点:

散步是心脏手术后最重要的活动. Aim for three or four walks a day, and feel free to take them outside. As you feel ready to do more, start by increasing your distance, then your speed.
Keep your activity at a level where you can carry on a conversation. 如果说话有困难，放慢语速. 如果你需要休息的话.

如需更多支持，请参阅 UCSF心脏康复与健康中心.