全胸腔镜下Box Lesion射频消融术治疗心房颤动近中期效果评估  

Early and mid-term outcomes of total thoracoscopic Box Lesion radiofrequency ablation in patients with atrial fibrillation

作　　者：康哲锋 石峻[1] 郭应强[1] KANG Zhefeng;SHI Jun;GUO Yingqiang(Department of Cardiovascular Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]四川大学华西医院心脏大血管外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2021年第9期1066-1071,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的评估全胸腔镜下Box Lesion射频消融术治疗心房颤动的近中期疗效。方法回顾性分析我院心脏外科2011年11月至2018年3月31例行全胸腔镜下Box Lesion射频消融术的心房颤动患者临床资料,其中男23例、女8例,平均年龄(66.17±8.32)岁。所有患者均不伴有需要手术处理的严重器质性心脏病。结果阵发性心房颤动20例,持续性心房颤动8例,长程持续性心房颤动3例。29例患者完成3年随访,2例患者于术后6个月失访。所有患者均成功完成手术,平均手术时间为(113.00±26.00)min,无围手术期死亡及相关并发症发生,全部患者术后立即转复为窦性心律。术后住院期间5例患者出现心房颤动,电复律后恢复为窦性心律。术后1、2和3年窦性心律维持率分别为62.9%、55.9%和52.4%,随访期间无患者死亡,未观察到手术相关并发症发生。结论全胸腔镜下Box Lesion射频消融术在保证手术效果的同时手术时间较短,手术创伤小,手术相关并发症少。Objective To evaluate the early and mid-term outcomes of total thoracoscopic Box Lesion radiofrequency ablation in patients with atrial fibrillation.Methods The clinical data of 31 patients with atrial fibrillation who underwent total thoracoscopic Box Lesion radiofrequency ablation between November 2011 and March 2018 at the Department of Cardiac Surgery in our hospital were retrospectively analyzed,including 23 males and 8 females at an average age of 66.17±8.32 years.All patients did not have concomitant severe organic heart disease which required surgical intervention.Results There were 20 patients with paroxysmal atrial fibrillation,8 with persistent atrial fibrillation,and 3 with long-standing persistent atrial fibrillation.Twenty-nine patients got the 3-year follow-up,and 2 patients were lost to the follow-up 6 months after the surgery.The procedure was successfully performed in all patients,with an average operation time of 113.00±26.00 min.There was no perioperative death or related complication.All patients were restored to sinus rhythm immediately after surgery.Five patients got atrial fibrillation during postoperative hospitalization,which reverted to sinus rhythm after electrical cardioversion.The rate of sinus rhythm maintenance was 62.9%,55.9%and 52.4%in postoperative 1,2 and 3 years,respectively.No patient died during the period,and no procedure-related complication was observed.Conclusion Total thoracoscopic Box Lesion radiofrequency ablation effectively shortens operation time,and reduces surgical trauma and procedure-related complications,meanwhile,ensures the surgical outcomes.

关 键 词：心房颤动 射频消融 全胸腔镜手术 微创手术 

分 类 号：R654.2[医药卫生—外科学]