房间隔穿刺法对儿童及青少年患者左侧房室旁道的射频消融治疗

Transseptal approach for radiofrequency ablation of left-sided accessory pathways in children

目的探讨房间隔穿刺方法（ＴＳ）对儿童及青少年患者左侧房室旁道射频消蚀（ＲＦＣＡ）的成功率及安全性。方法共有３０例患者，平均年龄为１３±３岁，心动过速史３～５年，其中６例是因为动脉逆行法（ＴＡ）失败或操作困难，而对其进行房间隔穿刺射频消融治疗的。结果３０例患者均成功的进行了ＲＦＣＡ，无一例发生与ＴＳ有关的并发症；操作时间９３±３５分钟，Ｘ线投照时间２７±１２分钟，放电功率１８±６Ｗ。结论ＴＳ法对儿童及青少年患者左侧房室旁道的ＲＦＣＡ具有较好的成功率和安全性；ＴＳ法可避免动脉系统有关的并发症。

Objective To discuss success rate and safety of radiofrequency catheter ablation (RFCA) of leftsided accessory pathways with transseptal approach (TS) in children. Methods Thirty patients, aged 13±3 years, were involved in the study. The history of paroxysmal tachycardia was as long as 35 years. Among them, 6 cases had undergone unsuccessful ablation with retrograde transaortic approach (TA). Results All patients were successfully treated with RFCA. No complication occurred. Procedure time was 93±35 min. Xray flueroscopy time was 27±12 min. Conclusion The results demonstrated that TS technique used for RFCA of leftsided accessory pathways in children and youths is safe and highly effective. With this method one could avoid complications associated with arterial system. Integrating TS and TA are suggested.