Vasconcelos José Tarcísio Medeiros de, Scanavacca Maurício Ibrahim, Sampaio Roney Orismar, Grinberg Max, Sosa Eduardo Argentino, Oliveira Sergio Almeida de
Instituto do Coração, Hospital das Clínicas, FMUSP, São Paulo, Brazil.
Arq Bras Cardiol. 2004 Sep;83(3):211-8; 203-10. doi: 10.1590/s0066-782x2004001500004. Epub 2004 Sep 13.
To determine the effectiveness of surgical isolation of the left atrial posterior wall encompassing the ostia of the pulmonary veins for the treatment of atrial fibrillation of rheumatic etiology.
Prospective and randomized study of patients with rheumatic mitral valve disease, persistent atrial fibrillation for 6 months or longer, age < or = 60 years, and left atrial diameter < or = 65 mm. The patients were randomly distributed into 2 groups as follows: surgical valvular treatment (control group) and surgical valvular treatment associated with isolation of the left atrial posterior wall according to the "cut-and-sew" technique (treated group).
Twenty-nine individuals were operated upon, 27 of whom (13 in the control group and 14 in the treated group) were regularly followed up. The patients of both groups did not differ in regard to their basal characteristics. The mean follow-up time was 11.5 months in the control group and 10.3 months in the treated group. The cumulative frequencies of the patients without atrial fibrillation were significantly greater in the treated group both in the perioperative (P = 0.0035) and late (P = 0.0430) phases.
Surgical isolation of the left atrial posterior wall encompassing the ostia of the pulmonary veins is an effective form of treating atrial fibrillation in rheumatic mitral valve disease.
确定围绕肺静脉开口进行左心房后壁手术隔离治疗风湿性病因心房颤动的有效性。
对患有风湿性二尖瓣疾病、持续性心房颤动6个月或更长时间、年龄≤60岁且左心房直径≤65mm的患者进行前瞻性随机研究。患者被随机分为两组：手术瓣膜治疗（对照组）和根据“切割-缝合”技术进行手术瓣膜治疗并联合左心房后壁隔离（治疗组）。
29例患者接受手术，其中27例（对照组13例，治疗组14例）接受定期随访。两组患者的基础特征无差异。对照组平均随访时间为11.5个月，治疗组为10.3个月。在围手术期（P = 0.0035）和后期（P = 0.0430），治疗组无房颤患者的累积频率均显著更高。
围绕肺静脉开口进行左心房后壁手术隔离是治疗风湿性二尖瓣疾病心房颤动的一种有效方式。
