摘要
目的总结梅氏微创消融术治疗房颤的经验和平均随访2年的临床结果。方法2010年6月至2015年5月，采用梅氏微创消融术治疗孤立性房颤患者353例，男240例，女113例；年龄（59．7±8．5）岁。阵发性房颤186例，非阵发性房颤167例。手术经左胸路径，在全胸腔镜下施行，房颤消融术式包括双极消融钳行双侧环肺静脉消融、连接两侧肺静脉的左心房顶部和左心房后壁线性消融，Marshall韧带、心外膜自主神经节消融和左心耳切除等。结果全组手术（92．3±19．1）min，无中开胸手术者。无置入起搏器等并发症和死亡。患者住院（8．5±2．1）天。术后随访（25．0±15．1）个月，308（90．1％）例维持窦性心律，34例不能维持窦性心律。术后复查，无卒中、左心房血栓和肺静脉口狭窄。结论梅氏微创消融术治疗孤立性房颤的疗效满意，不仅可以有效地恢复窦性心律，还可以降低术后卒中的发生率，值得进一步推广。
Objective To sunomanize the experience of consecutive 353 patients and mean 2-years follow-up following Mei mini maze procedure for atrial fibrillation. Methods Between June 2010 and May 2015,353 patients（240 males, 113 fe- males） of atrial fibrillation received this therapy. The age of these patients were（59.7 ± 8.5） years. Among them, 186 were with paroxysmal and 167 were with non-paroxysmal. The procedure, through three ports on left chest wall, included pulmonary vein isolation and ablations of the roof and posterior wall of left atrium which were achieved by bipolar radiofrequency ablation. Ganglionic plexus ablation was made by the ablation pen. Left atrial appendage was excluded. Results Durations of their pro- cedures were（92.3 ± 19.1 ） mins. No conversion to sternotomy or pacemaker implantation occurred and none of the patients died. The hospital stay was （8.5 ±2.1 ） days. The mean follow-up duration was （25.0 ±15.1 ） months. 308 （90.1% ） pa- tients were in sinus rhythm. 34 patients could not maintain sinus rhythm. Stroke, thrombus in the left atrium and stenosis of pulmonary vein were not found after their procedures. Conclusion Mei mini maze procedure is a safe, effective, and appro- priate treatment for AF, which restores sinus rhythm and may be associated with the prevention of AF-related stroke. It deserv- ed to be promoted in future.
出处
《中华胸心血管外科杂志》
CSCD
2015年第11期670-673,共4页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
国家自然科学基金（81570290）
上海市科委科技项目（15411952600）
上海申康医院发展中心基金（SHDC12014107）
新华医院院基金（13YJ29）
关键词
心房颤动
心脏外科手术
微创外科
消融
Atrial fibrillation
Cardiac surgical procedures
Minimal invasive surgery
Ablation
