胸腔镜辅助下微创射频消融治疗房颤6例分析  

Video-assisted minimal invasive surgical procedure for atrial fibrillation:a report of 6 cases

作　　者：张科峰[1] 徐东[1] 尚学斌[1] 刘燕晖[1] 李洪利[1] 刘飞[1] 姚青[1] 李雅琼[1] 王晓亮[1] 

机构地区：[1]首都医科大学宣武医院心脏中心,北京100053

出　　处：《北京医学》2012年第8期753-755,共3页Beijing Medical Journal

摘　　要：目的总结胸腔镜辅助下微创外科射频消融治疗单纯性心房颤动的经验和疗效。方法 2009年1月至2010年12月对6例单纯性房颤患者施行胸腔镜辅助下微创房颤射频消融手术,6例均为男性,平均年龄56.8岁,3例术前吸烟,2例合并高血压病,均为阵发性房颤,未接受过导管消融治疗。术前经食道超声证实无左房血栓,术前左房直径平均41.67mm。所有患者均在胸腔镜辅助下行双侧肺静脉前庭隔离、Marshall韧带切断、左心耳切除,但均未行心外膜标测,3例行肋间神经注射止痛。结果本组患者平均手术时间233min,均手术顺利,术后平均住院日9d,无围术期死亡。出院时窦性心律比例为50.0%(3/6),随访时间17～39个月,随访时窦性心律比例为83.3%(5/6)。随访期间无血栓及栓塞事件发生。结论胸腔镜辅助微创外科射频消融治疗单纯性心房颤动创伤小、恢复快、安全性高,中期疗效理想。Objective To evaluate the safety and efficacy of video-assisted minimal invasive surgical procedure for atrial fibrillation. Methods From January 2009 to December 2010, 6 patients were performed video-assisted minimal in- vasive surgical procedure for AF. AU of the patients who were 56.8 years old in average were male. There were 3 patients had a history of smoking and 2 patients had hypertension. All patients had paroxysmal AF. Preoperative TEE showed no LA thrombus and the diameter of LA was 41.67 mm in average. All patients underwent the minimal invasive surgical procedure including PV isolation, marshall ligament removal and excision of LAA. Results The mean operative time was 233 min and the mean post-operative hospital stay was 9 days. There were no peri-operative deaths. At discharge, 50% of all patients were in sinus rhythm. Patients were followed-up by 17-39 months. During follow-up time, 83.3% of all patients were in sinus rhythm. No thromboembolic event was observed during the follow-up period. Conclusion Video-assisted minimal invasive surgical procedure for AF is simple, safe and effective.

关 键 词：心房颤动 外科治疗 微创 

分 类 号：R541.75[医药卫生—心血管疾病]