Sueda T, Shikata H, Orihashi K, Mitsui N, Nagata H, Matsuura Y
First Department of Surgery, Hiroshima University School of Medicine, Minami-ku, Japan.
Surg Today. 1996;26(2):135-7. doi: 10.1007/BF00311779.
We describe herein the successful treatment of a patient with chronic atrial fibrillation (AF) associated with mitral valve stenosis and regurgitation, achieved by performing a modified maze procedure on the left atrium alone. The patient was a 51-year-old man who had suffered from intractable AF for 17 years, causing multiple cerebral emboli and palpitations. He had undergone open mitral commissurotomy and balloon commissurotomy 15 and 7 years ago, respectively. On admission, an echocardiogram revealed mitral valve restenosis and thrombosis in the left atrial appendage. Prosthetic valvular replacement was performed following isolation of all pulmonary veins with cryoablation to the posterior wall of the left atrium and excision of the left atrial appendage. Postoperatively, the AF disappeared and echocardiogram demonstrated a left atrial kick in the mitral valvular inflow without any evidence of thrombosis in the left atrium. Thus, we believe that our modified "left side only" maze procedure is a simple and efficient method for the treatment of chronic AF with mitral valve disease.
我们在此描述了一名患有慢性心房颤动（AF）并伴有二尖瓣狭窄和反流的患者的成功治疗案例，该治疗通过仅对左心房进行改良迷宫手术实现。患者为一名51岁男性，患有顽固性房颤17年，导致多次脑栓塞和心悸。他分别在15年前和7年前接受了二尖瓣直视交界切开术和球囊交界切开术。入院时，超声心动图显示二尖瓣再狭窄和左心耳血栓形成。在对左心房后壁进行冷冻消融隔离所有肺静脉并切除左心耳后，进行了人工瓣膜置换术。术后，房颤消失，超声心动图显示二尖瓣流入道有左心房搏动，左心房无血栓形成迹象。因此，我们认为我们改良的“仅左侧”迷宫手术是治疗伴有二尖瓣疾病的慢性房颤的一种简单而有效的方法。
