在微创冠状动脉旁路移植术时治疗心房颤动是否可行？
Is it feasible to treat atrial fibrillation at the time of minimally invasive coronary artery bypass grafting?
机构信息
Department of Cardiothoracic Surgery, Division of Cardiac Surgery, University of Pittsburgh Medical Center, Erie, Pennsylvania.
Department of Surgery, Division of Cardiac Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
出版信息
Curr Opin Cardiol. 2024 Nov 1;39(6):491-495. doi: 10.1097/HCO.0000000000001173. Epub 2024 Aug 13.
PURPOSE OF REVIEW
Coronary artery bypass grafting remains the most common operation performed by cardiac surgeons. As a result, a cardiac surgeon with a typical practice will most commonly encounter atrial fibrillation when performing coronary artery bypass grafting. In this review, we first emphasize the importance of treating atrial fibrillation in patients undergoing coronary bypass grafting. We review benefits of concomitant surgical ablation and its importance relative to complete coronary revascularization. We then discuss options to treat atrial fibrillation in a more minimally invasive manner in these patients, while still preserving treatment efficacy.
RECENT FINDINGS
Surgical ablation at the time of coronary artery bypass grafting surgery could be as important as complete revascularization. Bi-atrial ablation provides superior rhythm control compared to left-sided ablation only.
SUMMARY
We highlight various options for surgical ablation at the time of coronary artery bypass grafting surgery, and provide an algorithm for ablation in individual patients.
目的综述
冠状动脉旁路移植术仍然是心脏外科医生最常进行的手术。因此，具有典型手术经验的心脏外科医生在进行冠状动脉旁路移植术时最常遇到心房颤动。在本次综述中，我们首先强调了在接受冠状动脉旁路移植术的患者中治疗心房颤动的重要性。我们回顾了同期手术消融的益处及其相对于完全冠状动脉血运重建的重要性。然后，我们讨论了在这些患者中以更微创的方式治疗心房颤动的选择，同时仍然保持治疗效果。
最近的发现
冠状动脉旁路移植术时的手术消融可能与完全血运重建一样重要。双心房消融与仅左心房消融相比，提供了更好的节律控制。
总结
我们强调了冠状动脉旁路移植术时手术消融的各种选择，并为个别患者的消融提供了一个算法。
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