Key result
Trans-axillary aortic valve replacement was successfully performed in 5 patients with aortic regurgitation, resulting in no operative mortality and a mean postoperative hospital stay of 14.8 days.
Case Report (n=5)
No
Trans-axillary aortic valve replacement with endoscopic assistance is a feasible minimally invasive approach that avoids sternotomy and rib transection.
May support sternotomy-sparing options in aortic regurgitation; hypothesis-generating and requires prospective validation before practice change.
大動脈弁に対する低侵襲手術は胸骨部分切開や右傍胸骨切開といったアプローチが主流であるが，新たな方法として右腋窩小切開アプローチによる大動脈弁置換術を開始した．手術は7 cmの右腋窩縦切開による第4肋間開胸，第6肋間から5 mmのフレキシブル内視鏡を挿入して行った．体外循環は大腿動静脈にて確立した．この方法で5例の大動脈弁置換術を行い，平均手術時間312分，平均人工心肺時間217分，平均大動脈遮断時間139分，術後人工呼吸管理時間は平均4.2時間で，手術死亡は認めず，術後入院期間は平均14.8日であった．右腋窩小切開アプローチによる大動脈弁置換術は，従来の方法と比べ骨を切開する必要がなく，傷も目立たないため，早期社会復帰が期待できる新たな低侵襲の術式と考える．
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Aoki et al. (2013) conducted a case report in Aortic regurgitation (n=5). Trans-axillary aortic valve replacement (TAX AVR) was evaluated on Operative mortality and surgical times. Trans-axillary aortic valve replacement was successfully performed in 5 patients with aortic regurgitation, resulting in no operative mortality and a mean postoperative hospital stay of 14.8 days.
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