迷宫手术治疗二尖瓣病并心房纤颤──附1例报告

１９９４年９月我们成功的采用了迷宫手术治疗心房纤颤１例。患者女性，４２岁，患风湿性心脏病二尖瓣狭窄和关闭不全，左房血栓，伴１年房颤史，彩色多普勒示左房明显扩大（５６ｍｍ）。手术在全麻中度低温体外循环下进行，术中行二尖瓣置换和左房血栓取除。并按标准Ｃｏｘ迷宫手术设计治疗房颤，即在两侧心房作若干切口，结合深低温冷冻技术，根除两侧心房可形成大折返环的病理基础。术后第３天患者恢复窦性心律，术后一月复查心功良好。彩色多普勒证实在房明显缩小（４１ｍｍ），心房恢复正常收缩功能。

THE TREATMENT OF MITRAL VALVE DISEASE ASSOCIATED WITH ATRIAL FIBRILLATION BY MAZE PROCEDURE

A42-year-old female suffering from rheumatic heart disease with mitral stenosis and regurgitation, atrial thrombus and one year history of atrial fibrillation was treated successfully with Maze operation September, 1994.A,remarkably enlarged left atrium(56 mm)was well presented by colorechocardiography.Mitral valve replacement and excision of the left atrial thrombus were carried out under cardiopulmonary bypass at a temperature of 25C Atrial fibrillation was corrected with standard Cox-Maze technique,i.e,several atrial incisions and cryoablation )were employed to eliminate pathological mechanisms which might result in large reentrant circuits in the right and left atria.Sinal rhythm was recovered at the third day postoperatively. A desirable cardiac function was restored in the patient about 30 days after the operation Echocardiography showed that the inner diameter of the left atrium decreased to 41mm and the atrial contractile function was recovered.