二尖瓣手术并射频消融迷宫术治疗房颤  

Efficacy of radiofrequency Maze Ⅲ procedure for atrial fibrillation combined with mitral valve surgery：a controlled study

作　　者：王春生[1] 王邵华[1] 陈昊[1] 洪涛[1] 丁文军[1] 赵强[1] 

机构地区：[1]复旦大学附属中山医院心外科,上海200032

出　　处：《中华胸心血管外科杂志》2007年第1期22-24,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的评价二尖瓣手术并射频消融迷宫手术（Maze Ⅲ）治疗二尖瓣病变合并房颤的安全性和疗效。方法2003年1月至10月行二尖瓣手术及射频消融迷宫手术66例为研究组，同期二尖瓣病变合并房颤仅行二尖瓣手术的66例为对照组。两组术前数据差异无统计学意义，随访并比较分析两组房颤的消除率、手术疗效和术后并发症的差异。结果平均主动脉阻断时间研究组较对照组长（12．61±3．56）min，两组手术死亡率和并发症率差异无统计学意义。术后即刻、出院时及术后1年以上研究组与对照组的房颤消除率分别为100％、63．7％、76．2％与57．6％、18．2％、14．8％（P〈0．001）。研究组窦性心律恢复率明显高、脑梗发生率低、心功能恢复好。结论心内直视手术合并射频消融行迷宫手术可有效消除房颤，不增加心内手术的风险，安全、有效。而单纯二尖瓣手术未处理房颤者，术后房颤多数仍存在。Objective To evaluate the efficacy of radiofrequency Maze Ⅲ procedure for atrial fibrillation combined with mitral valve surgery. Methods From January 2003 to October 2004, 66 patients underwent radiofrequeney Maze Ⅲ procedure for atrial fibrillation combined with mitral valve surgery （study group） .They were compared to 66 patients with atrial fibrillation who underwent mitral valve surgery without Maze procedure during the same period （control group）. Patients in the two groups were similar in age, gender, preoperative NYHA heart function classification, duration of atrial fibrillation, preoperative left atrial dimension, and type of valvular diseases and combined procedure. The elimination rate of atrial fibrillation, operative outcome and postoperative complication were retrospective analyzed in two groups. Results The duration of aortic cross damp were （ 12.61 ± 3.56） minutes longer in study group than control group. However, mortality and morbidity were similar in two groups. The elimination rate of atrial fibrillation were 100%, 63.7% and 76.2% at postoperative moment, the time of discharge and 1 postoperative year for study group, and 57.6%, 18.2% and 14.8% for control group （ P 〈 0.001 ）. More sinus rhythm recoverly, less thromboembolic events and better heart function reoverly were achieved in study group during follow-up. Conclusion Radiofrequency Maze Ⅲ procedure proved reliable and efficient technique for atrial fibrillation combined by mitral valve diseases, most patients remain in atrial fibrillation after mitral valve without Maze procedure.

关 键 词：心房颤动 心脏瓣膜疾病 心脏外科手术 

分 类 号：R686[医药卫生—骨科学]