摘要
作者自１９９５年５月至１９９６年１０月共作２０例慢性心房颤动的迷宫手术和二尖瓣替换或修复术。术中心外膜标测结果左房多为扑动（１４／２０），右房则往往是颤动（１８／２０）。无早期死亡。２０例随访３个月以上，其中１４例随访在１年以上，经电生理检查均为窦性心率，房室同步活动，不能诱发房颤；经多普勒超声心动图检查，左和右心房输出功能正常。晚期死亡１例，手术后４个半月死于急性坏死性肝炎。对迷宫手术作了一些改进，术后早期从未出现房颤和房扑，并对慢性房颤合并二尖瓣病的电生理机制、手术适应证和迷宫手术效果的评价作了讨论。
From May 1995 to October 1996,20 patients with mitral valve disease underwent the maze procedure for chronic atrial fibrillation and mitral valve replacement or mitral valvuloplasty.Epicardial mapping data demonstrated that the large macrorecurre flutter circuit was located in left atrium (14/20) and complex fibrillation in right atrium (18/20) of the majority of patients.No early death occurred.20 patients were followed up for at least 3 months (range 3～20 months) and 14 patients for at least 1 year after operation,sinus rhythm and atrioventricular synchrony were restored (100%),atrial fibrillation was not induced by electrophysiologic study.The right and left atrial transport function was preserved (100%) by Doppler echocardiogram tracings.One patient died from acute necrotic hepatitis,4 and half months after operation.Cox maze procedure was modified,atrial flutter and atrial fibrillation never occurred.In this study,the electrophysiologic mechanism of chronic atrial fibrillation associated with mitral valve disease,indications of operation and clinical results are discussed.
出处
《中华外科杂志》
CAS
CSCD
北大核心
1997年第11期670-674,I099,共6页
Chinese Journal of Surgery
