中国体外循环杂志2018，Vol.16Issue(1)：29-32,4.DOI:10.13498/j.cnki.chin.j.ecc.2018.01.08
冷冻消融迷宫术治疗瓣膜病合并心房颤动的围术期管理
The perioperative care for Cox Maze prodecure using cryoablation in treatment of atrial fibrillation associated with valvular heart disease
摘要
Abstract
Objective To summarize the experience of perioperative care for Cox Maze prodecure using cryoablationin treatment of atrial fibrillation (AF) associated with valvular heart disease. Methods Clinical data of 65 patients who underwent Cox Maze prodecure using cryoablation in our center between October 2015 and June 2017 were retrospectively analyzed. There were 24 male and 41 female patients with the age of 37-71 (58.33±9.01)years. The AF duration was 0.5-240(48.86±74.46)months, and the left atrial diameter was 34-59(49.09±5.93) mm. Results There was no perioperative death. The aortic-clamp time was 44-159(92.40±30.58) min, and the cardiopulmonary bypass time was 101-229(156.60±35.57) min. The bleeding volume was 200-600(340.00±76.38) ml. The assisted mechanical ventilator time was 15-48(23.29±11.22) h, and the ICU stay time was 16-96(41.57±31.41)h. Seven patients (10.77％) received cardioversion, and 27 patients (41.54％) received temporary pacemaker implantation but none required permanent pacemaker. At discharge, there were 42 patients (64.62％) in sinus rhythm, eleven patients (16.92％) in atrial flutter rhythm, and 12 patients (18.46％) in atrial fibrillation rhythm. Conclusions Sufficient preoperative preparation, accurate and skilled operation, appropriate myocardial protection, closely monitoring of the heart rhythm, active precaution and therapy of postoperative arrhythmia, treatment directed by Swan-Ganz catheter and detailed discharge instruction are critical for the successful Cox Maze prodecure using cryoablation in treatment of atrial fibrillation associated with valvular heart disease.关键词
心房颤动/冷冻消融迷宫术/围术期Key words
Artial fibrillation/Cox Maze prodecure using cryoablation/Perioperative引用本文复制引用
肖雄,韩劲松,王辉山,尹宗涛,祝岩,韩宏光,金岩..冷冻消融迷宫术治疗瓣膜病合并心房颤动的围术期管理[J].中国体外循环杂志,2018,16(1):29-32,4.基金项目
辽宁省自然科学基金(20170540977) （20170540977）
