右胸小切口微創二尖瓣手術同期行心房顫動雙心房射頻消融術_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

于洋 ,  谷天祥 , 師恩祎 , 喻磊 , 王春 , 修宗誼

中國醫科大學附屬第一醫院心臟外科（沈陽?110001）;

Corresponding?author：

谷天祥, Email: cmugtx@sina.com.cn

Keywords：

心臟瓣膜疾病; 心房顫動; 外科手術; 微創性

DOI：

10.7507/1007-4848.20150046

Video：

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目的總結右胸前外側小切口微創二尖瓣手術同時行心房顫動（房顫）雙心房射頻消融術的臨床經驗。方法回顧性分析2012年1～10月中國醫科大學附屬第一醫院二尖瓣病變合并持續性心房顫動11例患者的臨床資料，其中男4例、女7例，年齡（54.5±6.5）歲。所有患者均經股動靜脈內插管建立體外循環，經第3或第4肋間入胸，經房間溝切口行二尖瓣手術，以單極筆行肺靜脈口射頻消融，以雙極筆經右心房切口行右心房及右側肺靜脈口射頻消融，封閉左心耳。縫合左右心房切口。2例行二尖瓣成形術，其余9例行二尖瓣置換術。結果手術時間（282.9±67.8）min，體外循環時間（165.7±39.8）min，主動脈阻斷時間（109.9±29.7）min，術后機械通氣時間（7.4±3.2）h，住ICU時間（26.5±5.3）h，胸腔引流量（119.7±24.5）ml。隨訪時間（5.1±1.9）個月，術后3個月復查，竇性心律8例，陣發性心房顫動1例，持續性心房顫動2例。結論經右胸前外小切口行微創二尖瓣手術同期行心房射頻消融術，術后恢復快，美容效果好，臨床療效滿意。

Citation： 于洋, 谷天祥, 師恩祎, 喻磊, 王春, 修宗誼. 右胸小切口微創二尖瓣手術同期行心房顫動雙心房射頻消融術. 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.	陳林, 肖穎彬.瓣膜置換同期雙極射頻消融治療合并心房顫動的早期療效分析.中國心血管病研究, 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.	師恩祎, 谷天祥.右胸前外側小切口再次和多次二尖瓣置換術.中華外科雜志, 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.	李巖, 孟旭. 56例微創外科治療單純性心房顫動的臨床經驗.心肺血管病雜志, 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. 陳林, 肖穎彬.瓣膜置換同期雙極射頻消融治療合并心房顫動的早期療效分析.中國心血管病研究, 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. 師恩祎, 谷天祥.右胸前外側小切口再次和多次二尖瓣置換術.中華外科雜志, 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. 李巖, 孟旭. 56例微創外科治療單純性心房顫動的臨床經驗.心肺血管病雜志, 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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右胸小切口微創二尖瓣手術同期行心房顫動雙心房射頻消融術

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