ObjectiveTo evaluate the effect and experience of monopolar or bipolar radiofrequency ablation for organic heart disease with atrial fibrillation under the open heart surgery. MethodsWe retrospectively analyzed the clinical data of 305 patients with organic heart disease such as atrial fibrillation underwent the open heart surgery in Changle People's Hospital and Shanghai Renji Hospital between December 2004 year and December 2013 year. There were 188 male and 117 female patients at age of 38 to 81 years. The patients were divided into three groups according to monopolar or bipolar radiofrequency ablation used. There were 128 patients in a monopolar group, 165 patients in a bipolar group, and 12 patients in a combined group with monopolar radiofrequency ablation plus bipolar radiofrequency ablation. ResultTwo patients died after operation. There were 249 patients (81.6%) with sinus rhythm after operation. Sinus rhythm was restored 78.9% in the monopolar group compared with 83.6% in the bipolar group with a statistical difference (P>0.05). We followed up the patients for 3 to 85 (38.2±15.4) months after operation. There were no statistical differences in sinus rhythm rates after following-up 0.5 year (80.5% vs. 83.9%, P>0.05), 1 year (78.4% vs. 83.3%, P>0.05), 2 years (76.5% vs. 81.1%, P>0.05), and 5 years(73.8% vs. 77.1%, P>0.05). ConclusionMonopolar or bipolar radiofrequency ablation for atrial fibrillation with open heart surgery is an effective method, especially in long-term effect. There was no significant difference between the monopolar group and the bipolar group in effect. Bipolar radiofrequency ablation can reduce the ablation time.
ObjectiveTo evaluate the effects of modified left ventricular reconstruction (LVR) and linear repair (LR) to post-infarct left ventricular aneurysm (LVA) and summarize the surgical experience of LVA. MethodsFrom May 2004 to December 2011, 47 patients were admitted in the Department of Cardiovascular Surgery, Renji Hospital Affiliated to Medical College of Shanghai Jiaotong University. There were 25 patients underwent LVR (group LVR, including 21 males and 4 females), 18 patients underwent LR (group LR, including 14 males and 4 females) and 4 patients underwent directly sutured (including 3 males and 1 female). Among them, 42 patients underwent coronary artery bypass grafting (CABG). During 6-24 months'follow-up, left ventricular ejection fraction (LVEF), quality of life and activity were measured. ResultsPostoperative LVEF was significantly higher than preoperative LVEF in group LVR(49.2%±13.6% vs. 32.5%±12.9%, P < 0.05) and group LR (47.5%±11.6% vs. 36.9%±11.6%, P < 0.05). One patient died in LR group (5.5%) and 1 died in LVR group (4.0%), no death occurred in directly sutured surgery. Total mortality was 4.2%. ConclusionLVR and LR are both effective treatment for LVA. Personalized treatment can receive satisfactory short-and long-term outcomes.