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  

Efficacy of Radiofrequency Modified Maze Procedure Combined with Open-heart Surgery for Atrial Fibrillation

作　　者：王邵华[1] 王春生[1] 

机构地区：[1]复旦大学附属中山医院心脏外科

出　　处：《中国胸心血管外科临床杂志》2006年第5期302-306,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

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.

关 键 词：心房颤动 迷宫手术 射频消融 心内直视手术 

分 类 号：R654.2[医药卫生—外科学]