右胸小切口微创二尖瓣手术同期行心房颤动双心房射频消融术_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

于洋 ,  谷天祥 , 师恩祎 , 喻磊 , 王春 , 修宗谊

中国医科大学附属第一医院心脏外科（沈阳 110001）;

Corresponding author：

谷天祥, Email: cmugtx@sina.com.cn

Keywords：

心脏瓣膜疾病; 心房颤动; 外科手术; 微创性

DOI：

10.7507/1007-4848.20150046

Video：

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目的总结右胸前外侧小切口微创二尖瓣手术同时行心房颤动（房颤）双心房射频消融术的临床经验。方法回顾性分析2012年1～10月中国医科大学附属第一医院二尖瓣病变合并持续性心房颤动11例患者的临床资料，其中男4例、女7例，年龄（54.5±6.5）岁。所有患者均经股动静脉内插管建立体外循环，经第3或第4肋间入胸，经房间沟切口行二尖瓣手术，以单极笔行肺静脉口射频消融，以双极笔经右心房切口行右心房及右侧肺静脉口射频消融，封闭左心耳。缝合左右心房切口。2例行二尖瓣成形术，其余9例行二尖瓣置换术。结果手术时间（282.9±67.8）min，体外循环时间（165.7±39.8）min，主动脉阻断时间（109.9±29.7）min，术后机械通气时间（7.4±3.2）h，住ICU时间（26.5±5.3）h，胸腔引流量（119.7±24.5）ml。随访时间（5.1±1.9）个月，术后3个月复查，窦性心律8例，阵发性心房颤动1例，持续性心房颤动2例。结论经右胸前外小切口行微创二尖瓣手术同期行心房射频消融术，术后恢复快，美容效果好，临床疗效满意。

Citation： 于洋, 谷天祥, 师恩祎, 喻磊, 王春, 修宗谊. 右胸小切口微创二尖瓣手术同期行心房颤动双心房射频消融术. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2015, 22(2): 168-170. doi: 10.7507/1007-4848.20150046 Copy

1.	Alvarez JM, Deal CW. Repairing the degenerative mitral valve:tento fifteen-year follow-up. J Thorac Cardiovasc Surg, 1996, 112(2):238-247.
2.	Handa N, Schaff HV, Morris JJ, et al. Outcome of valve repair and the Cox maze procedure for mitral regurgitation and associated atrial fibrillation. J Thorac Cardiovasc Surg, 1999, 118(4):626-635.
3.	陈林, 肖颖彬.瓣膜置换同期双极射频消融治疗合并心房颤动的早期疗效分析.中国心血管病研究, 2012, 10(2):141-144.
4.	Nardi P, Mve Mvondo C, Scafuri A, et al. Left atrial radiofrequency ablation associated with valve surgery:midterm outcomes. Thorac Cardiovasc Surg, 2013, 61(5):392-397.
5.	Aybek T, Dogan S, Risteski PS, et al.Two hundred forty minimally invasive mitral operations through right minithoracotomy. J Ann Thorac Surg, 2006, 81(5):1618-1624.
6.	师恩祎, 谷天祥.右胸前外侧小切口再次和多次二尖瓣置换术.中华外科杂志, 2012, 8(50):757-758.
7.	Wolf RK, Schneeberger EW, Osterday R, et al. Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation. J Thorac Cardiovasc Surg, 2005, 130(3):797-802.
8.	Lee AM, Clark K, Bailey MS, et al. A minimally invasive cox-maze procedure operative technique and results. Innovations, 2010, 5(4):281-286.
9.	李岩, 孟旭. 56例微创外科治疗单纯性心房颤动的临床经验.心肺血管病杂志, 2008, 27(3):129-133.
10.	Gillinov AM, Svensson LG. Ablation of atrial fibrillation with minimally invasive mitral surgery. Ann Thorac Surg, 2007, 84:1041-1042.
11.	Jeanmart H, Casselman F, Beelen R, et al. Modified Maze during endoscopic mitral valve surgery:the OLV clinic experience. Ann Thorac Surg, 2006, 82(5):1765-1769.

1. Alvarez JM, Deal CW. Repairing the degenerative mitral valve:tento fifteen-year follow-up. J Thorac Cardiovasc Surg, 1996, 112(2):238-247.
2. Handa N, Schaff HV, Morris JJ, et al. Outcome of valve repair and the Cox maze procedure for mitral regurgitation and associated atrial fibrillation. J Thorac Cardiovasc Surg, 1999, 118(4):626-635.
3. 陈林, 肖颖彬.瓣膜置换同期双极射频消融治疗合并心房颤动的早期疗效分析.中国心血管病研究, 2012, 10(2):141-144.
4. Nardi P, Mve Mvondo C, Scafuri A, et al. Left atrial radiofrequency ablation associated with valve surgery:midterm outcomes. Thorac Cardiovasc Surg, 2013, 61(5):392-397.
5. Aybek T, Dogan S, Risteski PS, et al.Two hundred forty minimally invasive mitral operations through right minithoracotomy. J Ann Thorac Surg, 2006, 81(5):1618-1624.
6. 师恩祎, 谷天祥.右胸前外侧小切口再次和多次二尖瓣置换术.中华外科杂志, 2012, 8(50):757-758.
7. Wolf RK, Schneeberger EW, Osterday R, et al. Video-assisted bilateral pulmonary vein isolation and left atrial appendage exclusion for atrial fibrillation. J Thorac Cardiovasc Surg, 2005, 130(3):797-802.
8. Lee AM, Clark K, Bailey MS, et al. A minimally invasive cox-maze procedure operative technique and results. Innovations, 2010, 5(4):281-286.
9. 李岩, 孟旭. 56例微创外科治疗单纯性心房颤动的临床经验.心肺血管病杂志, 2008, 27(3):129-133.
10. Gillinov AM, Svensson LG. Ablation of atrial fibrillation with minimally invasive mitral surgery. Ann Thorac Surg, 2007, 84:1041-1042.
11. Jeanmart H, Casselman F, Beelen R, et al. Modified Maze during endoscopic mitral valve surgery:the OLV clinic experience. Ann Thorac Surg, 2006, 82(5):1765-1769.

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右胸小切口微创二尖瓣手术同期行心房颤动双心房射频消融术

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