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成人合并房颤的完全性肺静脉异位引流的外科治疗:病例报告及文献复习。

Surgical Treatment of Total Anomalous Pulmonary Venous Drainage with Atrial Fibrillation in an Adult: A Case Report and Literature Review.

机构信息

Department of Cardiac Macrovascular Surgery, Affiliated Hospital of North Sichuan Medical College, Nanchong, Sichuan, P.R. China.

出版信息

Heart Surg Forum. 2022 Jan 18;25(1):E065-E068. doi: 10.1532/hsf.4313.

Abstract

Total anomalous pulmonary venous drainage (TAPVD) is caused by the absence of the congenital connection between the pulmonary vein and left atrium. This causes blood drainage into the right atrium, resulting in poor development of the left atrium and increasing the burden for the right atrium. It is accompanied by an atrial septal defect. TAPVD mostly is diagnosed during the fetal period and rarely is reported in adults. Atrial fibrillation (AF), a common arrhythmia, originates primarily from the joint of the pulmonary vein and left atrium, whereas AF originating from the right atrium has not been documented. Herein, we report the case of a 45-year-old male diagnosed with TAPVD accompanied by AF. After the correction of TAPVD and radiofrequency ablation (RFA) for AF performed under general anesthesia and cardiopulmonary bypass, the patient returned to normal sinus rhythm and showed no AF recurrence during two years of follow up.

摘要

完全性肺静脉异位引流(TAPVD)是由于肺静脉与左心房之间先天性连接缺失引起的。这导致血液流入右心房,导致左心房发育不良,并增加右心房的负担。它伴有房间隔缺损。TAPVD 主要在胎儿期诊断,在成人中很少报道。心房颤动(AF)是一种常见的心律失常,主要起源于肺静脉和左心房的连接处,而起源于右心房的 AF 尚未有记录。在此,我们报告了一例 45 岁男性 TAPVD 合并 AF 的病例。在全身麻醉和体外循环下行 TAPVD 矫正和射频消融(RFA)后,患者恢复正常窦性心律,在两年的随访中未出现 AF 复发。

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