心脏瓣膜置换同期行改良双极房颤射频消融术的安全性及有效性评价

目的评价心脏瓣膜置换同期行改良双极房颤射频消融术的安全性及有效性。方法回顾性分析2018年1月至2018年6月在安徽省立医院心脏大血管外科行心脏瓣膜置换手术的110例患者的临床资料,其中,将同期行改良双极房颤射频消融术的60例患者作为消融组,行单纯心脏瓣膜置换术的50例患者作为对照组。分析比较两组患者的术前一般资料、手术相关指标、术后病死率、并发症及窦性心律恢复情况。结果消融组患者主动脉阻断时间为(93. 93±30. 06) min,术后监护时间为(1. 97±0. 96) d,术后住院时间为(11. 83±5. 50) d,术后病死率为1. 67%,术后并发症发生率为21. 67%,与对照组相比,差异无统计学意义(P> 0. 05)。消融组患者体外循环时间为(164. 58±43. 92) min,手术时间为(300. 03±53. 43) min,术后窦性心律恢复率高,与对照组相比,差异有统计学意义(P <0. 05)。结论对于术前合并心房颤动的心脏瓣膜病患者,在瓣膜置换同期行改良双极房颤射频消融术治疗心房颤动手术安全可靠,术后窦性心律恢复率高。

Evaluation of safety and efficacy of cardiac valve replacement with modified bipolar radiofrequency ablation for atrial fibrillation

Objective To evaluate safety and efficacy of cardiac valve replacement with modified bipolar radiofrequency ablation for atrial fibrillation. Methods Retrospective analysis was performed on the clinical data of 110 patients who received cardiac valve replacement in the Department of Cardiovascular Surgery of Anhui Provincial Hospital Affiliated to Anhui Medical University from January to June in 2018. Sixty patients who received modified bipolar radiofrequency ablation for atrial fibrillation were selected as ablation group and 50 patients who underwent merely cardiac valve replacement as control. Statistic data of both groups were recorded in general preoperative data, surgical indicators,postoperative mortality and complications, and sinus rhythm recovery. Results Compared with control group, the variations ofablation group had no statistical significance in the duration of aortic occlusion[(93.93±30.06) min], postoperative monitoring[(1.97±0.96) d], postoperative hospitalization[(11.83 ±5.50) d], postoperative mortality (1.67%) and occurrence rate of complications (21.67%) (P>0.05). But the difference in the length of cardiopulmonary bypass[(164.58 ±43.92) min]and operation[(300.03 ±53.43) min] and high recovery rate of sinus rhythm in ablation group was statistically meaningful (P<0.05). Conclusions For patients with cardiac valvular disease complicated with preoperative atrial fibrillation, the operation of valve replacement with modified bipolar radiofrequency ablation for atrial fibrillation is safe and reliable with high postoperative sinus rhythm recovery rate.