冷迷宫手术对中枢门疾病早期和中期结局的影响:个案对应研究
Hiroyuki Nakajima1, Junjiro Kobayashi, Ko Bando
1Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
Circulation
|October 2, 2002
概括
结冰迷宫 (CM) 为心房动 (AF) 带有中心疾病提供了一种不那么侵入性的手术选择,它显示了较短的手术时间和与传统的Kosakai迷宫 (KM) 相比的节奏恢复. 这项研究证实CM作为AF的可靠治疗方法.
科学领域:
- 心血管外科心血管外科
- 心脏电生理学 心脏电生理学
- 最少侵入性手术的方法
背景情况:
- 迷宫手术有效地治疗心房动 (AF) 在患有 mitra 病的患者.
- 冷已经成为迷宫手术中心房切口的更简单的替代方案.
- 缺乏对冷处理可行性的比较研究.
研究的目的:
- 为了比较冷化迷宫 (CM) 与常规的科萨卡迷宫 (KM) 的早期和中期结局,用于中枢疾病中的AF.
- 在迷宫手术的背景下,评估冷化的可行性和有效性.
主要方法:
- 一项涉及110对匹配的CM或KM患者的比较研究.
- 患者因年龄,左心房尺寸,AF持续时间,之前的心脏手术和门手术而匹配.
- 测量结果包括心肺绕道时间,大动脉交叉合时间,胸管排水,鼻节律恢复,无AF复发和中风.
主要成果:
- 与KM相比,CM显示心肺绕道和大动脉十字时间明显缩短.
- 在CM组的患者手术后的胸管排水率较低.
- 出院时的鼻节律恢复率在CM (85.4%) 和KM (86.4%) 之间是可比的.
- 3年内持续性AF复发的精算自由度很高,并且在各组之间没有显著差异 (CM: 97.7%与KM: 90.4%).
- 在CM组中,在3年内无中风的精算自由率为99.0%.
结论:
- 与传统的Kosakai Maze (KM) 相比,冷凝迷宫 (CM) 提供了较短的大动脉十字时间和胸管排水.
- CM提供了与KM相比的鼻节律的恢复和维持.
- CM是一种可靠的,不那么侵入性的手术选择,用于治疗与中枢病相关的AF.
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