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心内直视手术加射频消融迷宫术治疗心房颤动的疗效分析 被引量:15

Efficacy of Radiofrequency Modified Maze Procedure Combined with Open-heart Surgery for Atrial Fibrillation
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摘要 目的评价心内直视手术加射频(RF)消融行迷宫(maze)手术的安全性和疗效。方法2003年1月至2004年10月共66例患者接受心内直视手术加RF消融maze手术,回顾性分析并随访比较手术前后心电图、超声心动图检查等指标,通过电话和信件了解心功能的变化和脑梗死的发生情况。结果RF消融maze手术所需时间为18.61±3.56min,全组无院内死亡,并发症发生率为15.15%(10/66)。随访时间14.25±6.47个月,随访率95.45%(63/66);最近的随访中心房颤动消除率80.95%(51/63),窦性心律恢复率74.60%(47/63),全组无1例发生脑梗死,77.78%(49/63)的患者术后心功能(NYHA)级。术后6个月随访心脏超声心动图检查提示左心房、左心室较术前明显缩小(P<0.01)。结论心内直视手术加RF消融行maze手术消除心房颤动安全有效。 Objective To evaluate the efficacy of Radiofrequency (RF) modified maze procedure combined with open-heart surgery for atrial fibrillation (AF). Methods From January 2003 to October 2004, 66 patients underwent the RF modified maze Ⅲ procedure for AF combined with open-heart surgery. The preoperative and postoperative indexes of electrocardiogram and echoeardiogram were compared through retrospective analysis and follow-up. Postoperative cardiac function and thromboembolie events were evaluated through telephone and mail. Results The time needed for RF modified maze Ⅲ was 18.61±3.56 min. There were no hospital deaths and the complications was 15.15%(10/66). Follow-up duration was 14.25±6.47 months with 95.45%(63/66) completion. At the lastest follow-up, the rate of freedom from AF was 80.95% (51/63)and the rate of restoration to sinus rhythm was 74.60%(47/63). No thromboembolic events was seen. 77.78%(49/63) of patients were in NYHA class Ⅰ. Significant decrease was seen in both left atrial dimension (LAD) and left ventricular dimension (LVD)(P〈0.01) more than 6 months after operation. Conclusion RF modified maze Ⅲ procedure as an adjunctive procedure is safe, time-sparing and effective in eliminating AF.
出处 《中国胸心血管外科临床杂志》 CAS 2006年第5期302-306,共5页 Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
关键词 心房颤动 迷宫手术 射频消融 心内直视手术 Atrial fibrillation Maze procedure Radiofrequency modified Open-heart surgery
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