Abstract: Objective To investigate the surgical efficacy and skill of video-assisted thoracic surgery for mitral valve disease. Methods Nineteen patients with mitral valve disease were randomly selected and treated by video-assisted thoracoscopic approach in our hospital from November 2020 to November 2021, including 7 males and 12 females. The age range was 24-76 years, with an average of 55 years. Preoperative echocardiography showed mitral insufficiency in 13 cases, including 12 cases of severe mitral insufficiency and 1 case of moderate mitral insufficiency. There were 6 cases of mitral stenosis with insufficiency, including 5 cases of severe mitral stenosis and 1 case of moderate mitral stenosis. All cases were established cardiopulmonary bypass using superior vena cava and femoral arteriovenous cannulation under general anesthesia. Mitral surgery was performed with the assistance of video-assisted thoracoscopy, in which 17 patients underwent mitral valve replacement and 2 patients underwent mitral valvuloplasty.Results All the 19 cases were successful, and no one was converted to open surgery. The operation time ranged from 4.45 h to 10.45 h, with an average of 6.9 h; The postoperative hospital stay ranged from 8 days to 20 days, with an average of 14 days. The patients were followed up for 1 month.The volume of left atrium and left ventricular end diastolic volume were significantly reduced （P < 0.05）, and cardiac function （NYHA grade） and quality of life （Minnesota Heart Failure Quality of life questionnaire） were significantly improved. Conclusion Video-assisted thoracic surgery for mitral valve disease is less trauma but considerable safety, curative efficacy, and it will become the main cardiac surgical modality in the near future.

Key words: mitral valve disease, minimally invasive, video assisted thoracoscopy, surgical operation

摘要： 目的 探讨电视胸腔镜手术治疗二尖瓣疾病的手术疗效和技巧。方法 随机选取我院2020年11月至2021年11月期间采用电视胸腔镜方式治疗二尖瓣疾病患者19例,其中男患者7例,女患者12例。平均年龄55岁。术前心脏超声提示二尖瓣关闭不全13例,重度12例,中度1例;二尖瓣狭窄合并关闭不全者6例,重度5例,中度1例。手术均在全麻下采用上腔静脉和股动静脉插管建立体外循环,电视胸腔镜辅助下行二尖瓣手术,其中二尖瓣置换术17例,二尖瓣成形术2例。结果 19例手术均顺利完成,无1例中转开放。手术时间4.45~10.45 h,平均6.9 h;术后住院时间8~20 d,平均14 d。术后随访1个月。患者左心房的体积和左心室舒张末容积明显缩小（P<0.05）,心功能（NYHA分级）和生活质量（明尼苏达心力衰竭生活质量问卷）均明显改善。结论 胸腔镜辅助下二尖瓣手术是一种创伤小,安全可靠,疗效确切的手术方法,且会成为未来主要的心脏手术方式。

关键词: 二尖瓣疾病, 微创, 胸腔镜辅助, 外科手术