Motion Picture

Aim: Degenerated valvular disease is more and more popular in the old patients.Traditional sternotomy cardiac operations have cause massive injury for these patients.To minimize the trauma, fullendoscopic cardiac operation is adopted via right mini-thoracotomy.Methods: The femoral vein and artery cannulations were placed guiding by transesophageal echocardiography (TEE) through this kind of peripheral cardiopulmonary bypass (CPB).Two small incisions were made in the parasternal 3rd intercostal for the main working port and camera.With the help of thoracoscope, surgeons used special instruments to conduct the valve maneuver.In this case, aortic valve was severely calcified, we carefully excised the valve to protect the aortic annulus.The residual calcified tissue were sucked preventing any embolism events.After sizing this patient's aortic annulus, 21 mm bioprosthesis valve was chosen, which was fit for her body surface area.We used continuous suture to implant the artificial bioprosthesis valve into the annulus, followed by the closure of the aortic wall.Results: In this very case, patient receive the bioprosthesis valve replacement through mini-incisions thoracotomy, which was successfully done uneventfully guiding by thoracoscope.Patient was discharged at the 8th day after the operation.Conclusion: In old patients, this full-endoscopic surgery could be applied in degenerated valvular disease.This kind of minimal-invasive operation could be completed and used in larger amount of patients.