Takeshita M, Furuse A, Kotsuka Y, Kubota H
Department of Cardio-thoracic Surgery, Faculty of Medicine, University of Tokyo, Japan.
Eur J Cardiothorac Surg. 1997 Sep;12(3):341-4. doi: 10.1016/s1010-7940(97)01202-5.
The transseptal superior approach can offer an excellent view of the mitral valve but the incision almost always transects the sinus node artery. The purpose of this study was to evaluate the sinus node function after mitral operation by this approach.
We reviewed the electrocardiograms of 76 patients who underwent mitral valve operations either via transseptal superior approach or via right lateral atriotomy. Nine patients who maintained the sinus rhythm for more than one year after surgery via the transseptal superior approach were selected for electrophysiological study to evaluate the sinus node function.
Postoperative electrocardiographic and electrophysiological studies revealed that the sinus node function after the transseptal superior approach was relatively well maintained for more than one year after the operation. The influence of the transseptal superior approach on the sinus node function in the mid-term postoperative period was apparently mild and did not cause a serious problem. However, some of the patients did show abnormal data in terms of sino-atrial conduction time and intrinsic heart rate. Therefore, further follow-up of the sinus node function is necessary in patients who underwent mitral surgery through the transseptal superior approach.
经房间隔上入路能提供二尖瓣的极佳视野，但该切口几乎总会横断窦房结动脉。本研究的目的是评估采用该入路进行二尖瓣手术后的窦房结功能。
我们回顾了76例行二尖瓣手术患者的心电图，这些患者手术入路为经房间隔上入路或右外侧心房切开术。选取9例经房间隔上入路手术后窦性心律维持超过1年的患者进行电生理研究，以评估窦房结功能。
术后心电图和电生理研究显示，经房间隔上入路术后窦房结功能在术后1年多时间内相对维持良好。经房间隔上入路对术后中期窦房结功能的影响明显较轻，未造成严重问题。然而，部分患者在窦房传导时间和固有心率方面确实显示出异常数据。因此，对于经房间隔上入路行二尖瓣手术的患者，有必要对窦房结功能进行进一步随访。
