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[大动脉转位心房矫治术后的节律和传导变化]

[Changes in rhythm and conduction after atrial correction of transposition of great vessels].

作者信息

Peteiro J, Aparici M, Hidalgo R, Castelló R, Arcas R, Sáenz de Buruaga J D

机构信息

Dpto. de Cardiología y Cirugía Cardiovascular, Clínica Universitaria, Facultad de Medicina, Universidad de Navarra.

出版信息

Rev Med Univ Navarra. 1989 Oct-Dec;33(4):191-7.

PMID:2490183
Abstract

Disorders of rhythm or conduction after correction by baffle of transposition of the great arteries (TGA) has been widely reported. In order to avoid them, transformations on Mustard original technique have been carried out. We analize here the incidence of arrhythmias during the follow up of 20 patients operated, following a modification of the Mustard technique, as well as the postoperative changes on the P wave. The 75% of the patients remained in sinus rhythm during the postoperative first year, but only 28% continued on it after 6 years. The rest of the patients presented nodal or low auricular rhythm, alternating with sinus rhythm. Seven patients fulfilled diagnostic criteria of sick sinus syndrome. Ninety five percent of the patients were asymptomatic. The 9 patients that performed a stress testing after operation presented sinus rhythm and heart rate acceleration, in spite of the rhythm was nodal at the beginning in 4 of them. The modifications of the Mustard technique apparently do not avoid the arrhythmias and disorders of conduction. Nevertheless, the exercise tolerance remain acceptable.

摘要

大动脉转位(TGA)经挡板矫正后的节律或传导紊乱已被广泛报道。为避免此类情况,对Mustard原技术进行了改进。在此,我们分析了20例接受Mustard技术改良手术患者随访期间心律失常的发生率,以及术后P波的变化。75%的患者在术后第一年维持窦性心律,但6年后仅有28%的患者仍维持窦性心律。其余患者表现为结性或低位房性心律,并与窦性心律交替出现。7例患者符合病态窦房结综合征的诊断标准。95%的患者无症状。9例术后进行应激试验的患者均表现为窦性心律且心率加快,尽管其中4例患者开始时心律为结性。Mustard技术的改良显然未能避免心律失常和传导紊乱。然而,运动耐量仍可接受。

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