瓣膜性心脏病伴永久性心房颤动患者术中消融疗效的分析  

Surgical Ablation of Permanent Atrial Fibrillation in Patients With Valvular Heart Diseases

作　　者：周睿[1] 徐方杰[1] 陈佩莉[1] 

机构地区：[1]上海市胸科医院心血管外科,200030

出　　处：《中国循环杂志》2009年第2期120-122,共3页Chinese Circulation Journal

摘　　要：目的:明确在对瓣膜性心脏病伴永久性心房颤动(房颤)患者的手术中进行房颤消融的有效性,以及影响消融成功率的主要因素。方法:从2005-09至2007-12,对57例患者施行了瓣膜手术,并在术中进行了房颤消融。术前测量患者的左心室射血分数、左心室收缩末期容积、左心室舒张末期容积、左心房直径、肺动脉压,并与年龄、性别、主动脉阻断时间。术后进行随访,分析影响消融成功的关键因素。结果:全组围手术期死亡2例,随访2～24个月,保持窦性心律者为39例(70.9%,n=55)。结论:在瓣膜手术中施行房颤消融安全、有效,影响消融成功率的唯一因素为左心房大小。Objective ：To evaluate the efficacy of surgical ablation in patients with permanent atrial fibrillation and valvular heart diseases, and try to determine the key factors which affected the rate of success. Methods ： A total of 57 patients with atrial fibrillation and valvular heart diseases from September 2005 to October 2006 were treated in our hospital by surgical ablation using radio frequency energy during concomitant heart valve operation. The patients＇ age ranged from 20 to 69 years,with 26 male and 31 female. Their left ventricular ejection fraction （LVEF） , left ventricular end systolic volume （LVESV）, left ventricular end diastolic volume （LVEDV）, left atrium diameter （LA） , pulmonary artery pressure （PAP）, together with their age, gender and cross clamp time （CLAMP）were analyzed to determine the key factors which affected the surgical ablation results. Results：All patients were followed up from 2 to 24 months. There were 2 peri-operative deaths, and 39/55 （70. 9% ）had sinus rhythm during the period of follow up time. Conclusion ：The radio frequency ablation was an effective method to treat atrial fibrillation in patients with valvular heart diseases. The size of left atrium was the only factor related to the failure of the ablation procedure.

关 键 词：射频消融 心脏瓣膜疾病 心脏手术 

分 类 号：R541[医药卫生—心血管疾病]