双极射频消融及迷宫术治疗风湿性心脏病合并长期持续性心房颤动

The therapeutic effects of modified Cox-Maze Ⅲ procedure using bipolar radiofrequency ablation for rheumatic valve disease combined with permanent atrial fibrillation

目的评价应用双极射频消融系统同时行迷宫术（MazeⅢ）治疗风湿性心脏瓣膜病合并长期持续性心房颤动（房颤）的近期疗效。方法2007年5月至2008年5月，13例风湿性心脏瓣膜病合并长期持续性房颤患者在瓣膜置换术同时行双极射频消融Mazem术。患者年龄56．5（44—65）岁，房颤持续时间5（2—11）年，左心房内径（55．1±5．9）mm。随访并评价手术疗效。结果本组无死亡等严重并发症，平均主动脉阻断时间10min，术后即刻、出院时及平均随访（9．2±3．2）个月时房颤消融成功率分别为100％、84．6％及92．3％。结论瓣膜置换术同时行双极射频消融MazeⅢ术治疗风湿性心脏瓣膜病合并长期持续性房颤安全可行，近期疗效好。

Objectives The present study was designed to evaluates the short term effect of modified Cox-Maze m procedure using bipolar radiofrequency ablation （BPRF） on the combination of rheumatic valve disease and long-standing permanent atrial fibrillation（AF）. Methods Thirteen cases of rheumatic valve disease with permanent AF received BPRF modified Cox-Maze Ⅲ procedure using the Medtronic Cardioblate BP system from May 2007 to May 2008. The therapeutic effect was evaluated. Results The average age of the patients were 56. 5 （range 44-65） years,average duration of AF were 5 （2-11） years and the average left atrial diameter was （55.1 ±5.9） mm. No mortalities or severe complications were seen in all the 13 patients during the study period. The average time for cross clamping of the aorta was 10 min. The AF was disappeared in all 13 patients immediately after the procedure. Successful restoration of sinus rhythm has been achieved in 12 patients （92. 3% ） during the follow-up of 6-17 （9. 2± 3.2） months,while one patient had recurrence of AF. Conclusion The Cox-Maze Ⅲ procedure with BPRF using the Medtronic Cardioblate BP system is a safe and effective treatment for patients suffering from rheumatic valve disease combined with permanent AF.