合并心脏血管畸形的阵发性室上性心动过速的射频导管消融

对 8例心脏血管畸形合并室上性心动过速 (SVT)的患者进行了射频导管消融 (RFCA) ,其中 2例合并布 加氏综合征 ,1例肥厚型梗阻性心肌病 ,1例房间隔缺损 ,1例完全型矫正型大动脉转位 ,2例Ebstein畸形 ,1例二尖瓣重度狭窄。这 8例SVT心内电图与普通病例相比基本相同 ,但因心脏或大血管畸形 ,故操作过程有其特殊性。结果 :上述 8例患者全部消融成功 ,其中SVT合并完全型矫正型大动脉转位患者 2个月后心动过速复发 ,再次消融成功。对合并的心脏血管畸形除 1例Ebstein畸形和 1例完全型矫正型大动脉转位患者未接受进一步治疗外 ,其余均根据适应证进行了相应手术 ,2例布 加氏综合征进行了球囊扩张术 ,1例肥厚型梗阻性心肌病行室间隔化学消融术 ,1例房间隔缺损实施了Amplatzer伞闭术 ,1例Ebstein畸形行房化心室折叠术 ,1例二尖瓣重度狭窄患者行二尖瓣球囊成形术。结论 :合并心脏血管畸形的SVT进行RFCA安全、有效。

Radiofrequency Catheter Ablation of Supraventricular Tachycardias Combined With Cardiovascular Anormaly

Radiofrequency catheter ablation(RFCA) cured 8 patients who had supraventricular tachycardia(SVT) combined with cardiovascular anormaly, and two of them had Budd-Chiari syndromes, one had hypertrophic obstructive cardiomyopathy, one had atrial septal defect, one had complete corrected transposition of great artery, two had Ebstein′s anormalies, one had serious mitral stenosis. The intracardiograms of all the above 8 patients were not different from common SVT, and because of their cardiovascular anormalies, so their operation had specificity. Results:All the eight SVTs were successfully ablated, but the SVT, which were combined with complete corrected transposition of great artery reoccurred, and successfully ablated again. All cardiovascular anormalies except one Ebstein′s anormaly and one complete corrected transposition of great artery were respectively corrected in accordance with the indications, two Budd-Chiari syndromes were performed percutaneous transluminal angioplasty, one hypertrophy obstructive cardiomyopathy was performed percutaneous transluminal septal myocardial ablation, one atrial septal defect was occludded with Amplatzer, one Ebstein′s anormaly was successfully corrected, and one serious mitral stenosis was performed valvuloplasty. Conclusion: It is safe and effective to ablate the SVTs which are combined with cardiovascular anormaly.