[电视辅助微创心脏手术治疗心房颤动：57例报告]

[Video-assisted minimally invasive cardiac surgery for atrial fibrillation: a report of 57 cases].

作者信息

Cui Yong-qiang, Meng Xu, Li Yan, Gao Feng, Li Hui, Xu Chun-lei, Zeng Wen, Han Jie

机构信息

Atrial Fibrillation Center, the 9th Department of Cardiac Surgery, Beijing Anzhen Hospital of Capital Medical University, Beijing, China.

出版信息

Zhonghua Wai Ke Za Zhi. 2008 Jul 15;46(14):1051-3.

PMID:19094528

Abstract

OBJECTIVE

To evaluate the feasibility and the efficacy of a new video-assisted minimally invasive surgery for patients with atrial fibrillation (AF).

METHODS

From December 2006 to October 2007, 57 patients who were 56.4 years old in average underwent the video-assisted minimally invasive cardiac operation for AF, and there were 40 male patients. Thirty-eight patients were paroxysmal AF, 7 patients were persistent and 12 patients were long-standing persistent. Three patients had failed catheter ablation, and two patients had preoperative permanent pacemaker implantation. All patients went under the minimally invasive procedure. Intraoperative electrophysiological mapping were performed.

RESULTS

Mean operation time was 3.5 h. One patient was confirmed of left auricle thrombus, and one received concurrent epicardial cardiac resynchronization therapy during the procedure. There were no perioperative deaths. Acute respiratory failure occurred in 1 patient and acute heart failure in 1 patient after operation. Sixteen patients had electrical cardioversion after operation and during follow-up. At discharge, 78.9% (45/57) of all patients were in sinus rhythm (84.2% for paroxysmal AF, 71.4% for persistent AF, 66.7% for long-standing persistent AF). The patients were followed-up by 1 to 10 months. At 1 month after operation, overall 64.3% (36/56) were in sinus rhythm (67.6% for paroxysmal AF, 57.1% for persistent AF, 58.3% for long-standing persistent AF). At 3 months, overall 83.9% (47/56) were in sinus rhythm (86.5% for paroxysmal AF, 85.7% for persistent AF, 75.0% for long-standing persistent AF). At > or = 6 months, overall 87.0% (20/23) were in sinus rhythm (89.5% for paroxysmal AF, 75.0% for persistent AF). No thromboembolic event was observed during follow-up period.

CONCLUSION

The video-assisted minimally invasive cardiac surgery proves to be safe, less traumatic, and presents optimistic early outcomes for paroxysmal AF patients.

摘要

目的

评估一种用于心房颤动（AF）患者的新型电视辅助微创手术的可行性和疗效。

方法

2006年12月至2007年10月，平均年龄56.4岁的57例患者接受了用于AF的电视辅助微创心脏手术，其中男性患者40例。38例为阵发性AF，7例为持续性AF，12例为长期持续性AF。3例患者导管消融失败，2例患者术前植入了永久性起搏器。所有患者均接受了微创手术。术中进行了电生理标测。

结果

平均手术时间为3.5小时。1例患者被证实有左心耳血栓形成，1例在手术过程中同时接受了心外膜心脏再同步治疗。无围手术期死亡。术后1例患者发生急性呼吸衰竭，1例患者发生急性心力衰竭。16例患者在术后及随访期间接受了电复律。出院时，所有患者中有78.9%（45/57）处于窦性心律（阵发性AF为84.2%，持续性AF为71.4%，长期持续性AF为66.7%）。患者随访时间为1至10个月。术后1个月时，总体64.3%（36/56）处于窦性心律（阵发性AF为67.6%，持续性AF为57.1%，长期持续性AF为58.3%）。3个月时，总体83.9%（47/56）处于窦性心律（阵发性AF为86.5%，持续性AF为85.7%，长期持续性AF为75.0%）。在≥6个月时，总体87.0%（20/23）处于窦性心律（阵发性AF为89.5%，持续性AF为75.0%）。随访期间未观察到血栓栓塞事件。