瓣膜置换术同期双极射频消融治疗心房纤颤12例临床分析

目的:总结心瓣膜置换术同期行射频消融改良迷宫手术治疗心房纤颤的临床经验。方法:2010年5月至2011年5月,我科为收治的12例风湿性心脏病合并房颤心律的患者在行瓣膜置换手术同时行双极射频消融改良迷宫手术治疗心房纤颤。回顾性分析并随访比较手术前后心电图、超声心动图检查指标。结果:射频消融时间(25-52)分钟,平均45.2分钟。随访(3-12)个月,无1例死亡。窦性心律11例(91.7%),交界性心律1例(8.33%)。全组无Ⅲ度房室传导阻滞、无因出血二次开胸手术等并发症发生。结论:心瓣膜置换术同期行双极射频消融改良迷宫手术治疗心瓣膜病合并慢性心房颤动操作简单、并发症少,近期临床效果满意。

Surgical Treatment of Atrial Fibrillation with Modify Maze Procedure by Radiofreqency Ablation During Valve Replacement Procedure

Objective:To summarize the experiences of radiofrequency modified maze procedure combined with heart valve replacement in treatment of patients with rheumatic heart disease and atrial fibrillation(AF).Methods: From May 2010 to April 2011,12 patients,with rheumatic heart disease and AF,underwent the radiofrequency modified maze procedure combined with heart valve replacement.A retrospective analysis was carried out,preoperative records of electro-cardiogram and echo-cardiogram and those postoperative records in three to six months after surgery were compared to determine the efficacy of the surgery.Results: Radio frequency ablation time was 25 to 52 minutes(mean 45.2 minutes).In 3 to 12 months after surgery,there were 11 patients with sinus arrhythmia(91.7%),only one patient with junctional rhythm(8.33 %),There was no patients mortality during the perioperative period,there was no Ⅲ atrioventricular block.No patients needed secondary thoracotomy surgery because of hemorrhage.Conclusion: The radio frequency modified maze procedure combined with heart valve replacement is safe and effective in treating AF in patients with rheumatic heart valve disease and AF,and it is not only a simple operative procedure,but it is also a clinical improvement.