多切片计算机断层扫描准确量化MAZE手术后的左心房大小和功能.
Kazuo Yamanaka1, Masatoshi Fujita, Kazuhiko Doi
1Division of Cardiovascular Surgery, Takeda Hospital, Japan.
Circulation
|July 6, 2006
概括
在患有慢性心房动 (AF) 和中心疾病的患者中,MAZE程序有效地恢复了鼻节律. 然而,与冠状动脉旁路移植 (CABG) 相比,它导致左心房 (LA) 机械功能明显恶化.
科学领域:
- 心脏病学 心脏病学
- 心脏外科手术 心脏外科手术
- 电力生理学 电力生理学
背景情况:
- MAZE手术旨在恢复慢性心房动 (AF) 患者的鼻节奏和左心房 (LA) 机械功能.
- MAZE对LA几何和墙壁运动的确切影响,特别是在同时患有中枢病的患者中,需要进一步阐明.
研究的目的:
- 研究MAZE手术对左心房 (LA) 尺寸和机械功能的影响,在患有慢性心房 (AF) 和中心疾病的患者中.
- 为了比较MAZE后的LA几何和功能,与接受冠状动脉旁路移植 (CABG) 手术的对照组进行比较.
主要方法:
- 一项涉及14名患者的研究,他们接受了MAZE治疗慢性AF和心肌门手术,10名患者接受了CABG.
- 使用多切片计算机断层扫描 (MSCT) 进行LA体积和助推器功能的定量评估,手术后平均15-18个月.
- 使用内心放射频率切除进行的MAZE手术.
主要成果:
- 所有MAZE患者在手术后实现了无AF和心房失律的自由.
- 虽然LA体积在各组之间是可比的,但MAZE组表现出明显减少的LA射出分数 (15%与26%,P=0.004).
- 与CABG组相比,MAZE组的LA墙壁运动明显更差,尽管两者都向几何中心收缩.
结论:
- 射频除MAZE是一种安全有效的治疗方法,用于恢复长期AF患者的鼻节律.
- 慢性AF与关膜疾病相关,导致LA机械功能的扩散性恶化.
- 需要进行更多的MSCT研究,以便在MAZE后顺序评估LA功能,并无同时进行中膜手术.
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