Gillinov A Marc, Rice Thomas W
Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
Ann Thorac Surg. 2004 Nov;78(5):1836-8. doi: 10.1016/S0003-4975(03)01434-6.
Frequent palpitations with eating developed in a 62-year-old man with a history of typical gastroesophageal reflux successfully treated by Nissen fundoplication 5 years previously. A Holter monitor demonstrated paroxysmal atrial fibrillation associated with eating. Barium swallow showed a slipped Nissen fundoplication with herniation into the chest. Under a single anesthetic, the patient had median sternotomy and off-pump pulmonary vein isolation with a bipolar radiofrequency clamp and transabdominal redo-Nissen fundoplication. A 24-hour Holter monitor performed 6 weeks after operation demonstrated a normal sinus rhythm with no atrial fibrillation. Barium swallow demonstrated an intact infradiaphragmatic repair.
一名62岁男性，有典型胃食管反流病史，5年前成功接受了nissen胃底折叠术治疗，出现进食时频繁心悸。动态心电图监测显示与进食相关的阵发性心房颤动。吞钡检查显示nissen胃底折叠术移位并疝入胸腔。在单次麻醉下，患者接受了正中胸骨切开术，使用双极射频夹进行非体外循环下肺静脉隔离，并经腹再次行nissen胃底折叠术。术后6周进行的24小时动态心电图监测显示窦性心律正常，无房颤。吞钡检查显示膈下修复完整。
