Matsumoto Yasushi, Watanabe Go, Endo Masamitsu, Sasaki Hisao, Kasashima Fuminori
Department of Cardiovascular Surgery, National Kanazawa Hospital Department of General and Cardiothoracic Surgery, Kanazawa University School of Medicine, 1-1 Shimoishibikichio, Kanazawa 920-8650, Japan.
J Card Surg. 2003 Sep-Oct;18(5):415-8. doi: 10.1046/j.1540-8191.2003.02054.x.
The authors treated a 70-year-old woman with persistent atrial fibrillation associated with mitral valve stenosis. Restoration of sinus rhythm was achieved with encircling isolation of pulmonary vein orifices concomitant with mitral valve replacement. A vertical incision in the right side of left atrium was extended to the margin of the upper and lower left pulmonary vein orifices. Supplemental cryo-coagulation was applied to the remnant of the circular incision, avoiding the entire encircling incision. Consequently, all pulmonary veins were electrically isolated. Encircling pulmonary vein orifice isolation is less invasive than the MAZE procedure because of reductions in surgical time and cardiopulmonary bypass time, minimization of atrial incisions, and prevention of injury to the coronary artery. It is thus an effective option for selected patients with atrial fibrillation.
作者对一名70岁患有持续性心房颤动合并二尖瓣狭窄的女性患者进行了治疗。通过环绕隔离肺静脉开口并同时进行二尖瓣置换术，实现了窦性心律的恢复。在左心房右侧做一垂直切口，延伸至左上、下肺静脉开口边缘。对环形切口的残余部分进行补充冷冻消融，避开整个环形切口。结果，所有肺静脉均实现了电隔离。与迷宫手术相比，环绕肺静脉开口隔离术的侵入性较小，原因在于手术时间和体外循环时间缩短、心房切口最小化以及避免了冠状动脉损伤。因此，对于选定的心房颤动患者而言，这是一种有效的选择。
