Yang Song, Mei Bo, Feng Kangni, Lin Weibin, Chen Guangxian, Liang Mengya, Zhang Xi, Wu Zhongkai
The Second Cardiac Surgery Department of First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
The Cardiac Surgery Department of First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Heart Lung Circ. 2018 May;27(5):621-628. doi: 10.1016/j.hlc.2017.04.016. Epub 2017 May 24.
This retrospective study aimed to evaluate the long-term results of two kinds of surgical atrial fibrillation radiofrequency ablations in concomitant cardiac operations.
We enrolled 129 patients from January 2006 to December 2015 and performed cardiac operations concomitantly with surgical atrial fibrillation. The patients were divided into a biatrial MAZE group (94 patients) and a left atrial MAZE group (35 patients). A preoperative baseline was compared with intraoperative and postoperative data. Similarly, complications and follow-up results were compared. A matching process based on propensity-score was performed to equalise the potential prognostic factors in both groups and to formulate a balanced 2:1 matched cohort study.
There were four deaths (4.3%) in the biatrial MAZE group and one death in left atrial MAZE group due to multiple organ failures followed by low cardiac output. No permanent pacemaker implantations were used in either group. The sinus rhythm maintenance rates at the 6-month, 1-year, 6-year and 8-year follow-ups between the biatrial MAZE group and the left atrial MAZE group were not significantly different (84.7%, 83.3%, 67.3%, and 58.8% vs. 84.9%, 77.4%, 61.1%, and 50%, p>0.05). Similarly, between the propensity-score matched groups, there were no significant differences.
The left atrial MAZE ablation for the patients with mitral valve diseases who needed open cardiac operation was safe and effective when compared with the biatrial MAZE ablation group.
这项回顾性研究旨在评估两种外科房颤射频消融术在同期心脏手术中的长期效果。
我们纳入了2006年1月至2015年12月期间的129例患者,这些患者在进行心脏手术的同时接受了外科房颤治疗。患者被分为双房迷宫组(94例)和左房迷宫组(35例)。将术前基线与术中和术后数据进行比较。同样,对并发症和随访结果进行比较。进行基于倾向评分的匹配过程,以平衡两组潜在的预后因素,并制定一项平衡的2:1匹配队列研究。
双房迷宫组有4例死亡(4.3%),左房迷宫组有1例死亡,均因多器官功能衰竭继发低心排血量。两组均未使用永久性起搏器植入。双房迷宫组和左房迷宫组在6个月、1年、6年和8年随访时的窦性心律维持率无显著差异(分别为84.7%、83.3%、67.3%和58.8%,对比84.9%、77.4%、61.1%和50%,p>0.05)。同样,在倾向评分匹配组之间也无显著差异。
对于需要进行心脏直视手术的二尖瓣疾病患者,与双房迷宫消融组相比,左房迷宫消融术安全有效。