微波消融治疗风湿性心脏病二尖瓣置换术中房颤效果

Study on endocardial microwave ablation of atrial fibrillation in rheumatic lesion patients undergoing mitral valve replacement

目的探索在风湿性心脏病二尖瓣置换术中附加微波消融治疗房颤的疗效。方法将66例风湿性瓣膜病合并持续性心房颤动的患者随机分为两组,试验组33例在二尖瓣手术中行心内膜微波消融治疗,另外33例设为对照组单独行瓣膜手术。结果微波组主动脉阻断时间、体外循环时间长于对照组(分别为(63.818±17.738)minvs(47.545±18.018)min;(108.879±32.191)minvs(85.333±22.885)min,P<0.05);两组住院时间无显著差异((23.212±5.946)dvs(24.697±9.252)d,P>0.05)。术后两组均未出现严重并发症,未出现需要二次手术的情况。平均随访(2.3±1.4)年,微波组72.727%(24/33)维持窦性心律;对照组15.152%(5/33)为窦性心律,P<0.05。结论微波消融治疗房颤安全、有效,效果显著。

Objective To access the clinical effects of endocardial microwave ablation of atrial fibrillation （AF） on the rheumatic mitral lesion patients undergoing mitral valve replacement. Methods There 66 rheumatic valve disease patients complicated with persistent atrial fibrillation were randomly divided into Group A consisted of 33 patients received endocardial microwave blation when their mitral valve were replaced and Group B consisted of 33 patients underwent replacement alone as control group . Results The aortic cross-clamping time, cardiopulmonary bypass time in Group A were significantly longer than the control group （63.818±17.738min vs 47.545±18.018min; 108.879±32.191min vs 85.333± 22.885min,P〈0.05）; The duration of hospitalization were not significantly different in Group A and B（ Group A was 23.212± 5.946d vs Group B 24.697±9.252d,P〉0.05）.There were no serious complications were observed after surgery. After a followup of 2.3±1.4 years, the sinus rhythm was recovered in 72.727%（24/33） patients in Group A and 18.182%（6/33） in Group B（P〈0.05）. Conclusion Endocardial microwave ablation of AF during mitral valve replacement is safe and effective.