Objective To investigate the clinical significance of small incision thoracotomy cardiac surgery in the management of heart diseases.Methods A retrospective analysis was made on clinical data of 115 cases of heart diseases treated with small incision thoracotomy surgery from September 2001 to October 2004 in this hospital.Results There were 108 cases of operation through a right small thoracic incision, 5 cases of robot-assisted operations,and 2 cases of occlusion of atrial septal defect(ASD) through a right small thoracic incision.The extracorporeal circulation time was 21~155 min(mean,145?26 min) and the aorta occlusion time was 8~108 min(mean,28?19 min).No operation-related death was seen.Postoperatively,a re-operation of open surgery was required for stopping bleeding in 1 case(0.9%,1/115),pulmonary atelectasis occurred in 3 cases(2.6%,3/115),and cerebral infarction happened in 2 cases(1.7%,2/115).Follow-up checkups in 82 cases for 6~24 months(mean,18 months) revealed no thoracic deformity.Conclusions With advantages of minimal injury,less bleeding,and quick closure of thoracic incision,right small incision thoracotomy is a good approach for the correction of cardiac deformities.

Objective To share the experience of heart thransplantation. Methods 3 recipients with terminal myocardiosis were reviewed. The transplantation was performed with inferior and superior vena anastomofic technique. During perioperative period, we selected and maintained the recipients, protected donor-isolated heart, supported circulation,decreased immune reaction and controlled infections. Results All the 3 patients survived. Heart function improved from NYHA class 1V before heart transplant to NYHA class Ⅰ, Ⅱ. The follow-up time was 19 months ,28 months and 49 months respectively. Rejection occurred in two cases due to non-compliance to medication. Conclusions Suitable recipient, proper donor heart procurement and preservation, suitable maintenance of circulation, proper managements of anti-immunitive reaction, prevention of infections are critical for successfal heart transplantation. Medicine-take required may avoid or reduce rejection.