Maze procedure with radiofrequency ablation combin

e707004304 · Wysłany: Śro 22:13, 30 Mar 2011

Maze procedure with radiofrequency ablation combined with rheumatic valvular heart disease and the treatment of atrial fibrillation

Activity Chart Check: left atrium 50mm, left ventricular 49mn'l, right atrium 52mrn × 32mm, pulmonary artery systolic pressure 58mmH ~ g (7.9kPa), mitral regurgitation (one severe), tricuspid valve regurgitation (light degrees), pulmonary hypertension (mild); ECG: atrial fibrillation tips; x Line: changes consistent with rheumatic heart disease (mitral stenosis and regurgitation). 2 cases of cardiac function in patients with grade Ⅲ 1.2 treatments are routine chest incision after surgery,[link widoczny dla zalogowanych], heparin 3mg/kg, routine to establish cardiopulmonary bypass surgery in the beating by Cox maze under way before the right atrium parallel to the longitudinal incision to the inferior vena vein below the 1an, formed in its top cut apart, along the left atrial appendage, respectively, the circular structure of pulmonary vein radiofrequency ablation and pulmonary vein in the middle next to the double mitral ring the same radio frequency ablation (RF ablation instrument with the United States EP100, 8 ~ 20w increasing ,20 - 30s, with intimal surface of the naked eye Zhixin pale.) Mitral valve disease re-excision, implantation of artificial mechanical valve, sewn closed and the right atrial septum incision, open aortic cases were automatically reset after 2 jump. Aortic cross-clamping time of 99 ~ 106min, an average of 102min, the total bypass time 165 - 208min. 2 results of 2 patients after open heart cycle is automatically re-jump, atrial fibrillation disappeared. 1 case of resuscitation within 5min after a brief Ⅱ atrioventricular block, by using a small amount of isoproterenol, heart rate increased after the restoration of sinus rhythm, there was no complete atrioventricular block. The other can not be eradicated. Cox maze procedure for atrial fibrillation was designed to treat. Surgery is the main source of many abnormal pacemaker and atrial reentrant channel cut in addition to atrial fibrillation, up to radical results. Often complicated by atrial fibrillation in rheumatic heart disease, mitral valve disease, surgical mitral valve replacement to be implemented at the same time L. Classic maze procedure operation range, operation of technically complex, easy to damage the other organizations, trauma, surgery for a long time, myocardial protection are affected, there is risk of bleeding. Treatment of atrial fibrillation with radiofrequency ablation, atrial muscle injury can be continuous, transmural, showing coagulation necrosis, in order to achieve break reentrant ring, the purpose of eliminating atrial fibrillation. Since the RF ablation targeting difficult, replace the maze procedure for clinical application remains to be further research ~. We end units beating the maze procedure in the right atrial reentry and ectopic pacemaker off, left atrial part of the endocardial surface by direct ablation operation. Further mitral valve replacement surgery, significantly shorten the operation time, reduction of myocardial ischemic injury, postoperative atrial fibrillation disappeared, is a feasible and effective way to cure atrial fibrillation. Therefore, rheumatic valvular disease and mitral valve replacement in patients with atrial fibrillation at the same time provided by the classic maze procedure surgical cut right atrial diameters, left atrium using radiofrequency ablation treatment, also has a good effect on atrial fibrillation and significantly shorten the operation time, reduction of myocardial ischemic damage, less intraoperative and postoperative bleeding.