Ebstein畸形合并预激综合征的外科手术治疗

Surgical treatment of preexcitation syndrome in patents with Ebstein's anomaly

目的:探讨Ebstein畸形合并预激综合征的外科手术治疗。方法:Ebstein畸形合并预激综合征房室折返性心动过速患者10例,于三尖瓣成形或换瓣术同时,进行房室旁道的心外膜标测定位和外科切割术,其中3例左室收缩功能减低患者采用低温体外循环心脏不停跳手术方法。结果:10例患者心外膜检测检出13条旁道,术后1例心动过速复发,外科手术成功率为92.31%;3例采用不停跳手术方法患者术后恢复顺利。结论:Ebstein畸形合并预激综合征房室折返性心动过速,外科手术可同时治愈2种疾病,不停跳手术方法有较好的心肌保护作用,有助于术后心功能恢复。

Objective: To evaluate surgical treatment of atrioventricular reentrant tachycardia in patents with Ebstein's anomaly. Methods: Intraoperative mapping and surgical intervention were performed in 10 patients with Ebstein's anomaly and atrioventricular reentrant tachycardia. Surgical procedure of beating heart on cardiopulmonary bypass with mild hypothermia were applied in 3 patients with tachycardiomyopathy. Results: Thirteen accessory pathways were detected in 10 patients by intraoperative mapping. The success ful rate of surgical dissection accessory pathways was 92.31% (12/13) without significant complications. Patients with tachycardiomyopathy underwent beating heart surgical procedure recovered well postoperatively. Conclusion: Surgical management of atrioventricular reentrant tachycardia should be considered in patients with Ebstein's anomaly which is not only correcting the structural heart diseases but also abolishing tachycardia. The advantages of beating heart surgical procedure are satisfactory in myocardial protection effect and avoiding the normal conduction system injury.