直视下超声消融肺静脉治疗慢性房颤

目的　探讨术中直视下经球囊超声消融系统进行静脉消融治疗 5例慢性房颤的疗效。方法　选择 5例风湿性心脏病二尖瓣病变合并慢性房颤病人 ,采用球囊在体外循环直视下行肺静脉内超声消融 ,同时行二尖瓣置换术 ,消融部位为肺静脉根部 ,总计对 2 0根肺静脉进行了超声消融 ,消融温度 6 0℃ ,时间为 2 0 0s。结果　复跳后心外膜标测示 3例为窦性心律 ,术后平均随访 4 3(2 8～ 6 1)d ,仅 1例 (2 0 % )患者房颤未再发作。结论　心脏手术术中采用经球囊超声系统进行肺静脉消融操作方便 ,但效果仍有待进一步评价

Ultrasound Ablation in Pulmonary Vein for Treating Atrial Fibrillation During Cardiac Surgery

Objective To discuss the reaults of ultrasound ablation in pulmonary vein for treating chronic atrial fibrillation during cardiac surgery.Methods Five patients with rheumatic mitral valve diseases and chronic atrial fibrillation underwent ultrasound ablation in pulmonary vein during cardiac surgery of mitral valve replacement.Utrasound balloon was used to ablate roots of 20 pulmonary vein,with a temperatre of 60℃ and a time of 200 seconds.Results Three patients got sinus rhythm after recovery beating by epicardial maping.Only one case(20%) got fully free of atrial fibrillation after average 43 day followup(28 to 61days).Conclusion It was convenient to perform ultrasound ablation in pulmonay vein by using balloon ultrasound system during cardiac surgery,but its effectiveness still need to be evaluated.