微创冷冻消融迷宫Ⅳ手术治疗二尖瓣病变合并心房颤动的近中期结果  

Early and mid-term outcomes of concomitant cryosurgical Cox-MazeⅣprocedure in minimally invasive mitral valve surgery

作　　者：宋珑[1] 刘立明[1] 张昊[1] 胡建国[1] 罗成[1] 杨本立[1] SONG Long;LIU Liming;ZHANG Hao;HU Jianguo;LUO Cheng;YANG Benli(Department of Cardiovascular Surgery,The Second Xiangya Hospital,Central South University,Changsha,410011,P.R.China)

机构地区：[1]中南大学湘雅二医院心血管外科,长沙410011

出　　处：《中国胸心血管外科临床杂志》2021年第2期154-157,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金："十三五"国家重点研发计划课题(2018YFC1311204);湖南省科技创新计划项目(2017SK50116)。

摘　　要：目的分析胸腔镜辅助下微创切口二尖瓣手术同期行冷冻消融治疗心房颤动的近中期结果。方法回顾性分析中南大学湘雅二医院心血管外科2013年8月至2017年10月完成的68例胸腔镜辅助下右胸微创切口二尖瓣手术同期行冷冻消融治疗心房颤动患者的临床资料,其中男28例、女40例,平均年龄(38.7±9.3)岁。于术后定期复查24 h动态心电图观察心律情况。结果全组无手术死亡,1例再次开胸止血。出院时窦性心律转复率为95.8%。随访无死亡病例。术后第6个月、12个月、24个月、36个月的窦性心律转复率分别为93.5%、91.6%、90.3%、89.5%。结论胸腔镜辅助下微创切口二尖瓣手术合并心房颤动冷冻消融近中期结果安全可靠,心房颤动治疗效果确切。Objective To analyze the early and mid-term safety and effectiveness of concomitant cryosurgical Cox-MazeⅣprocedure in minimally invasive mitral valve surgery.Methods We retrospectively reviewed the clinical data of 68 patients(28 males and 40 females with a mean age of 38.7±9.3 years)who underwent concomitant cryosurgical Cox-MazeⅣprocedure in minimally invasive mitral valve and tricuspid surgery in the Department of Cardiovascular Surgery of the Second Xiangya Hospital from August 2013 to October 2017.The heart rhythm of the patients after surgery was supervised by 24 hour holter monitoring eletrocardiogram.Results No death occurred during operation and follow-up.One patient underwent reexploration for bleeding.The rate of sinus rhythm restored at the time of discharge was 95.8%.The rate of sinus rhythm restored at 6 months,12 months,24 months,36 months after surgery was 93.5%,91.6%,90.3%and 89.5%respectively.Conclusion Concomitant cryosurgical Cox-MazeⅣprocedure in minimally invasive mitral valve surgery is quite safe and effective in treatment of rheumatic mitral valve disease and atrial fibrillation in the early and mid-term follow-up.

关 键 词：微创二尖瓣手术 心房颤动 冷冻消融 迷宫Ⅳ手术 

分 类 号：R654.2[医药卫生—外科学]