心房颤动的手术治疗

Evaluationofthecardiacperformanceaftermazeprocedureinchronicatrialfibrilation

心房颤动的手术治疗心房颤动（房颤）的理想手术治疗应达到以下三个目的：（１）消除房颤恢复窦性心律；（２）重建和（或）维持房室同步活动；（３）恢复两心房传输功能，从而消除单房或双房的血流瘀滞以减低或消除血栓栓塞的危险。迄今为止，所有的非直视手术介入方法均...

MultidimensionalmethodsofanalysisbeyondstandardmeasurementofthesizeandthevolumewereundertakenbyusingM-modeand2-dimensionalechocardiogramstoevaluatechangesinleftatrium(LA)functionandeffectsofmazeprocedureoncardiacperformancein14rheumaticheartdisease(RHD)patientswithchronicatrialfibrilationand12healthypersons.LAstrokevolumeinRHDgroupwassignificantlygreaterinperioperativeperiodthanthenormal(25.14±7.88cm3vs18.69±3.56cm3,P<0.05).LAactiveemptyingvolumewasnotsignificantlydiffer-entinperioperationand3monthspost-operativelycomparedwiththehealthygroup.LApassiveemptyingvolumewashigherthanthatofthehealthygroupinperioperativeperiodand3monthsafteroperation(8.58±2.74cm3and11.54±5.69cm3vs5.93±1.66cm3,P<0.05).LAejectionfrac-tionswerelowerthanthoseofthehealthygroup.LAkineticenergy(LAKE)wasgreaterinperioper-ativeperiodthanthatofthehealthygroup,andwasnotdiferent3monthsafteroperation.Theintraoperativetransesophagealechocardiograms(TEE)werestudiedusingtheDopplerflowvelocityspectraacrossthemitralvalveandthetricuspidvalveimmediatelyafterthemazeprocedureTEEdocumentedthe100%presenceofLAandRAcontractionfunction3monthsafteroperation.Thepost-operativeLVperformanceshowedthatLVDd,LVDs,LVEDVandLVESValim-provedsignificantlythanthoseinpreoperativeperiod,andhadnodifferencecomparedwiththehealthygroup3monthsafteroperation.