梅氏微创心房颤动射频消融术后左心房僵硬综合征的回顾性临床分析  

Stiff left atrial syndrome after Mei mini maze procedure for atrial fibrillation:A retrospective study

作　　者：杨琦[1] 丁士骜 江雪艳[1] 袁源[1] 刘浩[1] 梅举[1] YANG Qi;DING Shiao;JIANG Xueyan;YUAN Yuan;LIU Hao;MEI Ju(Department of Cardiothoracic Surgery,Xinhua Hospital,School of Medicine,Shanghai Jiao Tong University,Shanghai,200092,P.R.China)

机构地区：[1]上海交通大学医学院附属新华医院心胸外科,上海200092

出　　处：《中国胸心血管外科临床杂志》2024年第3期434-438,共5页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金面上项目(81974023)。

摘　　要：目的 分析梅氏微创心房颤动(房颤)射频消融术后发生左心房僵硬综合征(stiff left atrial syndrome,SLAS)的临床特点,探索其发生的危险因素及治疗措施。方法 回顾性分析2010—2020年在上海交通大学医学院附属新华医院心胸外科接受梅氏微创射频消融术患者的临床资料。根据术后早期是否发生SLAS将患者分为SLAS组和非SLAS组。对比两组患者一般资料、围术期超声心动图及实验室检验指标。结果 纳入患者1 056例,其中男672例(63.6%),平均年龄(63.6±9.3)岁。持续性房颤患者489例、阵发性房颤患者567例。全组患者中共有14例(1.3%)发生SLAS,平均发生时间为术后(2.1±1.1)d。全组患者平均随访时间(21.4±7.8)个月,SLAS组有2例患者在出院后再次发生SLAS,发生时间分别为术后3周、4周;非SLAS组患者出院后无SLAS发生。糖尿病、术前左心房内径小是术后发生SLAS的危险因素。SLAS患者经过充分的利尿治疗,预后良好。结论 梅氏微创房颤射频消融术后SLAS发生率低,多发生于术后早期,经充分利尿治疗后预后良好。Objective To analyze the clinical characteristics of stiff left atrial syndrome(SLAS)after Mei mini maze procedure for atrial fibrillation(AF),and to explore its risk factors and treatments.Methods We retrospectively analyzed the clinical data of the patients who underwent Mei mini maze procedure in Xinhua Hospital between 2010 and 2020.According to whether SLAS occurred in the early postoperative period,patients were divided into a SLAS group and a non-SLAS group.The basic data,perioperative echocardiogram and laboratory test indexes of the two groups were compared.Results A total of 1056 patients were collected.There were 672(63.6%)males with an average age of 63.6±9.3 years,including 489 patients with persistent AF and 567 patients with paroxysmal AF.Fourteen(14/1056,1.3%)patients developed SLAS,with an average occurrence time of 2.1±1.1 days after the surgery.The average follow-up time of the whole group was 21.4±7.8 months.Two patients in the SLAS group developed SLAS again after discharge,and the occurrence time was 3 weeks and 4 weeks after the operation,respectively;while no SLAS occurred after discharge in the non-SLAS group.Diabetes and small preoperative left atrial diameter were risk factors for SLAS after surgery.Patients with SLAS had a good prognosis after adequate diuretic therapy.Conclusion The incidence of SLAS after Mei mini maze procedure for AF is low,and it mostly occurs in the early postoperative period.After adequate diuretic treatment,the prognosis is good.

关 键 词：左心房僵硬综合征 心房颤动 梅氏微创房颤射频消融术 

分 类 号：R654.2[医药卫生—外科学]