Yu Yalu, Jiang Qin
School of Medicine, University of Electronic Science and Technology of China, 610054 Chengdu, Sichuan, China.
Department of Cardiac Surgery, Sichuan Provincial People's Hospital, Affiliated Hospital of University of Electronic Science and Technology, 610072 Chengdu, Sichuan, China.
Rev Cardiovasc Med. 2025 Apr 23;26(4):26841. doi: 10.31083/RCM26841. eCollection 2025 Apr.
As technology advances, surgical approaches for atrial fibrillation have diversified. Surgical treatments include Cox-Maze surgery, left atrial appendage occlusion, or closure using a clip. Cox-Maze surgery removes excessive cardiac electrical conduction pathways, ensures electrical signals propagate exclusively through the predetermined maze channel and restores normal heart rhythm. Left atrial appendage closure reduces the risk of long-term disability or death caused by left atrial appendage thromboembolism in patients with atrial fibrillation. These devices are constantly being refined, including bipolar radiofrequency clamps (monopolar or bipolar radiofrequency), left atrial appendage closure devices (external excision using staplers, internal ligation with biomatrix patch occlusion, external device placement with the AtriClip and Endoloop ligature). In addition to surgical interventions, surgical biomaterial materials with biocompatibility and electrical conductivity have emerged in the basic research phase of atrial fibrillation treatment. This review delineates the primary surgical techniques, emphasizing their safety and efficacy in treating atrial fibrillation. An introduction to commonly used surgical equipment is provided as a reference for the clinical management of atrial fibrillation.
随着技术的进步,心房颤动的手术方法日益多样化。手术治疗包括Cox迷宫手术、左心耳封堵术或使用夹子进行闭合。Cox迷宫手术去除过多的心脏电传导通路,确保电信号仅通过预定的迷宫通道传播,并恢复正常心律。左心耳闭合可降低心房颤动患者因左心耳血栓栓塞导致长期残疾或死亡的风险。这些装置在不断改进,包括双极射频夹(单极或双极射频)、左心耳闭合装置(使用吻合器进行外部切除、用生物基质贴片闭塞进行内部结扎、使用AtriClip和Endoloop结扎进行外部装置放置)。除了手术干预外,具有生物相容性和导电性的手术生物材料已出现在心房颤动治疗的基础研究阶段。本综述阐述了主要的手术技术,强调了它们在治疗心房颤动方面的安全性和有效性。还介绍了常用的手术设备,为心房颤动的临床管理提供参考。