迷宫手术对心房纤颤患者中风的影响

Impact of maze procedure on the stroke rate in patients with atrial fibrillatio

目的探讨迷宫手术对心房纤颤患者中风的影响。方法自1994年10月至1999年3月,我们对53例内科治疗无效的房颤患者进行了迷宫术治疗,其中有8例术时正患有中风,6例有中风史,3例术前曾有短暂性脑缺血(TIA)。结果迷宫术后53例患者经6.5年的随访,仅有1例(1.7%)近期有不严重的中风。结论迷宫术能非常显著的减少房颤合并中风的危险性。

Objective To study the impact of the maze procedure on the stroke rate in patients with atrial fibriUation. Methods During the past 6.5 yers,we have performed the maze procedure for the treatment of medically refractory atrial fibrillation in 53 patient,8 of whom presented with a history of having had a strok （n=6） or transient isehemic attack （n=3） before surgery. Results Among the 58 patients who had surgery, there were only 1 perioperative stroke（ 1.7% ）, and in the 58 patients followed for up to 6.5 years after the maze procedure,there has been only 1 late minor stroke that has now completely resolved. Conclusions The ability of the maze procedure to decreas the risk of stroke associated with atrial fibrillation so dramatically is likely due to the restoring of sinus rhythm and atrial transport function in combination with surgical removal or obliteration of the left atrial appendage, where most thrombi associated with atrial fibrillation develop.