Mavroudis Constantine, Deal Barbara J
Johns Hopkins Children's Heart Surgery, Florida Hospital for Children, Orlando, Florida, USA.
Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Transl Pediatr. 2016 Jul;5(3):148-159. doi: 10.21037/tp.2016.06.04.
Certain congenital heart anomalies make patients more susceptible to arrhythmia development throughout their lives. This poses the question whether prophylactic arrhythmia surgery should be incorporated into reparative open heart procedures for congenital heart disease. There is currently no consensus on what constitutes a standard prophylactic procedure, owing to the questions that remain regarding lesions to be performed; energy sources to use; proximity of energy source or incisions to coronary arteries, sinoatrial node, atrioventricular node; circumstances for right atrial, left atrial, or biatrial appendectomy; and whether to perform a right, left, or biatrial maze procedure. These considerations are important because prophylactic arrhythmia procedures are performed without knowing if the patient will actually develop an arrhythmia in his or her lifetime. By reviewing and summarizing the literature, congenital heart disease patients who are at risk for developing atrial arrhythmias can be identified and lesion sets can be suggested in an effort to standardize experimental protocols for prophylactic arrhythmia surgery.
某些先天性心脏异常使患者在其一生中更易发生心律失常。这就提出了一个问题，即预防性心律失常手术是否应纳入先天性心脏病的开放性心脏修复手术中。目前对于什么构成标准的预防性手术尚无共识，这是由于在以下方面仍存在问题：要施行的病变；所使用的能量源；能量源或切口与冠状动脉、窦房结、房室结的接近程度；右心房、左心房或双心房心耳切除术的情况；以及是否进行右心房、左心房或双心房迷宫手术。这些考虑很重要，因为预防性心律失常手术是在不知道患者一生中是否真的会发生心律失常的情况下进行的。通过回顾和总结文献，可以识别出有发生房性心律失常风险的先天性心脏病患者，并提出病变组合，以努力规范预防性心律失常手术的实验方案。
