中国现代医学杂志Issue(3)：115-119,5.DOI:10.3969/j.issn.1005-8982.2016.03.024
二尖瓣机械瓣置换术中闭塞左心耳预防风湿性心房颤动患者脑栓塞的临床研究
Left atrial appendage occlusion during mitral valve replacement for prevention of cerebral embolism in patients with rheumatic atrial fibrillation
刘胜中 1谭今 1于涛 1黄克力1
作者信息
- 1. 四川省医学科学院 四川省人民医院 心脏外科中心，四川 成都 610072
- 折叠
摘要
Abstract
Objective To investigate the safety of left atrial appendage occlusion by silk thread ligation during mitral valve replacement in patients with rheumatic heart disease and atrial fibrillation, and to evaluate its effectiveness for prevention of cerebral embolism. Methods From April 2012 to March 2014, 129 patients with rheumatic heart disease and atrial fibrillation underwent mitral valve replacement and left atrial ap-pendage occlusion by ligation using two silk threads from the outside of the heart (ligation group). The control group included 129 patients without ligation of left atrial appendage over the same period. The indexes related to the operation, and the incidence of postoperative complications and cerebral embolism during the follow-up period were compared between the two groups. Results There was no significant difference in the operation time, cardiopulmonary bypass time, clamp time, Intensive Care Unit stay time or the postoperative hospitaliza-tion time between both groups. There was no significant difference in the mortality rate or the incidence of postoperative complications including thoracotomy for hemostasis, low cardiac output syndrome, acute renal failure, pulmonary infection and sternal wound dehiscence between the two groups. No cerebral embolism oc-curred in the ligation group during the follow-up of (23.6±11.3) months in all the 127 patients, but 5 pa-tients suffered from cerebral embolism in the control group during the follow-up of (22.9 ±12.1) months in 126 patients , the difference was significant between the two groups ( < 0 . 05 ) . Conclusions Left atrial appendage occlusion by silk thread ligation during mitral valve replacement is simple and safe for patients with rheumatic heart disease and atrial fibrillation, and can reduce the incidence of cerebral embolism.关键词
左心耳结扎/左心耳闭塞/二尖瓣置换术/风湿性心脏病/心房颤动/脑栓塞Key words
left atrial appendage ligation/left atrial appendage occlusion/mitral valve replacement/rheumatic heart disease/atrial fibrillation/cerebral embolism分类
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刘胜中,谭今,于涛,黄克力..二尖瓣机械瓣置换术中闭塞左心耳预防风湿性心房颤动患者脑栓塞的临床研究[J].中国现代医学杂志,2016,(3):115-119,5.
