二尖瓣置换同期行双极射频消融术治疗风湿性二尖瓣病变合并心房颤动的疗效分析_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

邬晓臣 ,  张近宝 , 欧阳辉 , 岳琴 , 辛梅 , 李运明 , 辛东

;

Corresponding author：

张近宝, Email: zhangjb1@126.com

Keywords：

风湿性心脏病; 射频消融; 心房颤动

DOI：

10.7507/1007-4848.20140237

Video：

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目的分析二尖瓣置换同期行双极射频消融术治疗风湿性二尖瓣病变合并心房颤动的临床效果。方法 2009年6月至2012年6月成都军区总医院共收治风湿性二尖瓣病变合并心房颤动患者200例，其中男80例、女120例，年龄37～63（48.3±11.0）岁。根据是否同期行双极射频消融术将患者分为两组，试验组（n=100）患者瓣膜置换术同期行双极射频消融术，对照组（n=100）单纯行瓣膜置换术。结果试验组体外循环时间和主动脉阻断时间较对照组均显著延长［（64.6±12.7）min vs.（60.8±10.8）min，P=0.024；（55.3±12.1）min vs.（49.8±10.5）min，P=0.001］，住院费用显著增加［（11.2±3.5）万元vs.（9.8±2.2）万元，P=0.001］，死亡率差异无统计学意义（2% vs.1%，P=0.561）。试验组在术毕、术后１年时的心房颤动转复率均显著高于对照组（82.0% vs.27.0%，72.9% vs.9.6%，P<0.05）。结论二尖瓣置换同期行双极射频消融术治疗风湿性二尖瓣病变合并心房颤动患者是安全、有效的。

Citation： 邬晓臣, 张近宝, 欧阳辉, 岳琴, 辛梅, 李运明, 辛东. 二尖瓣置换同期行双极射频消融术治疗风湿性二尖瓣病变合并心房颤动的疗效分析. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2014, 21(6): 827-829. doi: 10.7507/1007-4848.20140237 Copy

1.	Sims JB, Roberts WC. Comparison of findings in patients with versus without atrial fibrillation just before isolated mitral valve replacement for rheumatic mitral stenosis(with or without associated mitral regurgitation). Am J Cardiol, 2006, 97(7):1035-1038.
2.	王辉山, 汪曾炜, 李新民, 等.双极射频消融迷宫术后同步电复律治疗心房颤动.中国胸心血管外科临床杂志, 2011, 18(4):359-361.
3.	陈林, 肖颖彬, 肖娟, 等.不同心肌保护方法在双瓣膜置换术中对心肌的保护作用.中国胸心血管外科临床杂志, 2012, 19(4):371-375.
4.	Chaiyaroj S, Ngarmukos T, Lertsithichai P. Predictors of sinus rhythm after radiofrequency maze and mitral valve surgery. Asian Cardiovasc Thorac Ann, 2008, 16(4):292-297.
5.	熊克品, 钱红波, 杨小龙, 等.心脏机械瓣膜置换术后抗凝治疗的安全性.中国胸心血管外科临床杂志, 2012, 19(1):88-89.
6.	肖锡俊, 朱喜亮, 唐红, 等.二尖瓣置换术后患者远期超声心动图特征及其临床意义.中国胸心血管外科临床杂志, 2013, 20(2):144-147.
7.	肖锡俊, 袁宏声, 唐红, 等.二尖瓣置换时采用盐水冲洗的射频改良迷宫手术治疗心房颤动.中华心律失常学杂志, 2006, 10(5):342-344.
8.	张培德, 王巍.心房颤动与心房纤维化的联系.中国胸心血管外科临床杂志, 2011, 18(6):561-564.
9.	Gillinov AM, McCarthy PM. Atricure bipolar radiofrequency clamp for intraoperative ablation of atrial fibrillation. Ann Thorac Surg, 2002, 74(6):2165-2168.
10.	盂旭, 王坚刚.心内直视下射频消融术治疗心房颤动.中华胸心血管外科杂志, 2005, 4(1):247-248.
11.	符竣, 王波, 陶凉, 等.两种不同射频消融方式治疗风湿性心瓣膜病合并永久性心房颤动的疗效比较.中国胸心血管外科临床杂志, 2013, 20(3):304-307.
12.	Beukema WP, Sie HT, Misier AR, et al. Predictive factors of susta-ined sinus rhythm and recurrent atrial fibrillation after a radiofrequency modified Maze procedure. Eur J Cardiothorac Surg, 2008, 34(4):771-775.
13.	Fasol R, Mdinhart J, Binder T. A modified and simplified radiofre-quency ablation in patients with mitral valve disease. J Thorac Cardiovasc Surg, 2005, 129(1):215-217.
14.	杨嵩, 张希, 唐白云, 等.永久性心房颤动外科双极射频消融术的效果.中国胸心血管外科临床杂志, 2012, 19(3):254-257.
15.	Kim KC, Cho KR, Kim YJ, et al. Long-term results of the Cox-Maze Ⅲ procedure for persistent atrial fibrillation associated with rheumatic mitral valve disease:10 year experience. Eur J Cardiothorac Surg, 2007, 31(2):261-266.
16.	Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59(1):17-29.

1. Sims JB, Roberts WC. Comparison of findings in patients with versus without atrial fibrillation just before isolated mitral valve replacement for rheumatic mitral stenosis(with or without associated mitral regurgitation). Am J Cardiol, 2006, 97(7):1035-1038.
2. 王辉山, 汪曾炜, 李新民, 等.双极射频消融迷宫术后同步电复律治疗心房颤动.中国胸心血管外科临床杂志, 2011, 18(4):359-361.
3. 陈林, 肖颖彬, 肖娟, 等.不同心肌保护方法在双瓣膜置换术中对心肌的保护作用.中国胸心血管外科临床杂志, 2012, 19(4):371-375.
4. Chaiyaroj S, Ngarmukos T, Lertsithichai P. Predictors of sinus rhythm after radiofrequency maze and mitral valve surgery. Asian Cardiovasc Thorac Ann, 2008, 16(4):292-297.
5. 熊克品, 钱红波, 杨小龙, 等.心脏机械瓣膜置换术后抗凝治疗的安全性.中国胸心血管外科临床杂志, 2012, 19(1):88-89.
6. 肖锡俊, 朱喜亮, 唐红, 等.二尖瓣置换术后患者远期超声心动图特征及其临床意义.中国胸心血管外科临床杂志, 2013, 20(2):144-147.
7. 肖锡俊, 袁宏声, 唐红, 等.二尖瓣置换时采用盐水冲洗的射频改良迷宫手术治疗心房颤动.中华心律失常学杂志, 2006, 10(5):342-344.
8. 张培德, 王巍.心房颤动与心房纤维化的联系.中国胸心血管外科临床杂志, 2011, 18(6):561-564.
9. Gillinov AM, McCarthy PM. Atricure bipolar radiofrequency clamp for intraoperative ablation of atrial fibrillation. Ann Thorac Surg, 2002, 74(6):2165-2168.
10. 盂旭, 王坚刚.心内直视下射频消融术治疗心房颤动.中华胸心血管外科杂志, 2005, 4(1):247-248.
11. 符竣, 王波, 陶凉, 等.两种不同射频消融方式治疗风湿性心瓣膜病合并永久性心房颤动的疗效比较.中国胸心血管外科临床杂志, 2013, 20(3):304-307.
12. Beukema WP, Sie HT, Misier AR, et al. Predictive factors of susta-ined sinus rhythm and recurrent atrial fibrillation after a radiofrequency modified Maze procedure. Eur J Cardiothorac Surg, 2008, 34(4):771-775.
13. Fasol R, Mdinhart J, Binder T. A modified and simplified radiofre-quency ablation in patients with mitral valve disease. J Thorac Cardiovasc Surg, 2005, 129(1):215-217.
14. 杨嵩, 张希, 唐白云, 等.永久性心房颤动外科双极射频消融术的效果.中国胸心血管外科临床杂志, 2012, 19(3):254-257.
15. Kim KC, Cho KR, Kim YJ, et al. Long-term results of the Cox-Maze Ⅲ procedure for persistent atrial fibrillation associated with rheumatic mitral valve disease:10 year experience. Eur J Cardiothorac Surg, 2007, 31(2):261-266.
16. Santarpino G, Rubino AS, Onorati F, et al. Atrial fibrillation ablation induces reverse remodelling and impacts cardiac function. Minerva Cardioangiol, 2011, 59(1):17-29.

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Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

二尖瓣置换同期行双极射频消融术治疗风湿性二尖瓣病变合并心房颤动的疗效分析

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