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find Keyword " 心脏外科手术" 2 results
  • 改良冲洗式双极射频消融手术治疗心房颤动

    目的 分析心瓣膜置换术中同期行改良冲洗式双极射频消融治疗心房颤动的临床效果。 方法 回顾性分析2009年4月至2011年6月安徽医科大学第二附属医院心瓣膜病合并心房颤动34例患者在体外循环下行心瓣膜置换术+改良冲洗式双极射频消融手术的临床资料,其中男21例,女13例;年龄41~76 (50.5±11.3)岁。风湿性心脏瓣膜病31例,心瓣膜退行性病变3例;合并慢性持续性/永久性心房颤动27例,阵发性心房颤动7例。均采用Medtronic Cardioblate 68000冲洗式双极射频消融系统进行消融操作。消融手术包括双侧肺静脉的环形隔离、左心耳切除、左右心房消融(改良Cox-mazeⅢ手术路径)和Marshall韧带切除。术后常规予胺碘酮治疗。 结果 全组无死亡,除2例术后并发Ⅲ○房室传导阻滞、安装永久性心脏起搏器外,其余患者未发生与消融相关的并发症。术后31例转为非心房颤动心律(窦性心律25例,结性心律4例,起搏心律2例),3例维持心房颤动心律。随访3~20个月,29例维持窦性心律(85.3%),3例心房颤动心律,2例起搏心律。 结论 改良冲洗式双极射频消融治疗心房颤动安全、有效。

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
  • Palliative Surgery for Patients with Complex Congenital Heart Diseases

    Objective To study palliative surgical strategies for patients with complex congenital heart diseases, and improve their clinical outcomes and survival rate.?Methods We retrospectively analyzed clinical data of 95 patients with complex congenital heart diseases who underwent palliative surgical repair in Union Hospital of Tongji Medical College,Huazhong University of Science and Technology from January 2004 to May 2011. There were 68 male patients and 27female patients with their age ranging from 1 month to 37 years. Modified Blalock-Taussig shunt (B-T shunt) was performed in 12 patients, modified Brock’s procedure in 23 patients, bidirectional Glenn procedure in 55 patients and pulmonary artery banding in 5 patients. Surgical strategies and influential factors of treatment outcomes were analyzed.?Results There were 10 in-hospital death with the overall mortality of 10.5% (10/95). All the surviving patients were discharged successfully. Main postoperative complications included low cardiac output syndrome, hypoxemia and pneumonia. All the surviving patients were followed up for 5 months to 6 years, and in New York Heart Association (NYHA) functional class ⅠorⅡduring follow-up. During follow-up, nine patients after modified Brock’s procedure received radical repair, and 6 patients after bidirectional Glenn procedure received total cavopulmonary connection.?Conclusion A considerable numberof patients with complex congenital heart diseases may miss their best timing for surgical repair, which significantlyinfluences their surgical outcomes. We need to choose best palliative surgical strategy for these patients according to their pulmonary artery development condition, heart malformation characteristics and final treatment goal.

    Release date:2016-08-30 05:50 Export PDF Favorites Scan
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