摘要
目的探讨二尖瓣置换合并射频迷宫术的体外循环 (CPB)方法。方法 :76例风湿性心脏二尖瓣病变合并房颤患者实施瓣膜置换时 ,采用心内直视射频消融迷宫术对其合并的心房纤颤予以治疗。先期的 13例 (A组 )患者在CPB转流阻闭升主动脉后进行射频消融术和二尖瓣置换 ;后期 6 3例 (B组 )采用阻断上下腔静脉后先射频消融右心房 ,再行二尖瓣置换和左房射频消融。结果 :A组 13例患者CPB转流 (10 4± 2 5 )min ,主动脉阻断 (6 1± 11)min。B组 6 3例患者CPB转流 (81± 19)min ,主动脉阻断 (47± 11)min ;应用冷晶体心肌保护患者开放升主动脉后心脏自动复跳率 5 5 .9% ,应用冷血心肌保护患者心脏自动复跳率 71.4 %。术后恢复窦性心律 6 4例 ,占 84 .2 %。结论 :在二尖瓣置换合并射频迷宫术的体外循环中阻闭升主动脉前先射频消融左房可以明显缩短体外循环时间和主动脉阻断时间 ;
Objective:To discuss the methods of cardiopulmonary bypass (CPB) for rheumatic heart disease using radiofrequency ablation maze procedure as valve replant were performed.Methods:After cross-clamped aortic,13(group A) of 76 cases underwent radiofrequency ablation maze procedure for right atrium;63 (group B) of 76 cases underwent radiofrequency ablation maze procedure for right atria before cross-clamped aortic during the CPB.Results:In group A,the duration of CPB was (104±18)minutes,and the duration of aorta cross-clamped was (61±11) minutes.In group B the duration of CPB was (81±19)minutes,and the duration of aorta cross-clamped was (47±11) minutes.When opened the cross-clamped aorta,the ratio of automatic heart beating was 64.5%.In crystalloid cardioplegia solution group,the ratio of heart automatic beating was 51.9%.In cold blood cardioplegia group,the ratio of heart automatic beating was 71.4%.After operation,there were 84.2%(64/76) cases recovered sinus rhythm.Conclusions:During mitral valve replant and radiofrequency ablation maze procedure using cold blood cardioplegia and first radiofrequency ablation right atria then cross-clamped aorta,those can strengthen myocardial protection and reduce the time of CPB.
出处
《中国现代医学杂志》
CAS
CSCD
2002年第3期10-11,14,共3页
China Journal of Modern Medicine
关键词
二尖瓣置换
射频消融
迷宫术
体外循环
Mitral Valve Replant
Radiofrequency
Maze Procedure
Cardiopulmonary
