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双入腔室的心室隔膜:避免导电损伤
Ajami Gikandi1, Jocelyn Davee1, Edward T O'Leary2
1Department of Cardiac Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Mass.
The Journal of thoracic and cardiovascular surgery
|September 28, 2024
概括
在心室隔离期间进行手术内导电映射可以提高预测心脏阻塞的准确性. 这种手术为Fontan手术提供了一种安全的替代方案,在特定患者中提供了良好的早期结果.
科学领域:
- 儿科心脏手术 儿科心脏手术
- 遗传性心脏病是一种先天性心脏病.
- 电子生理学 电子生理学
背景情况:
- 静脉隔离是先天性心脏病的一个复杂的程序.
- 尽管精确的导电位置预测,但完整的心脏阻塞仍然是一个重要的风险.
研究的目的:
- 评估在心室隔离期间手术内导电映射的实用性.
- 评估心室隔离的安全性和早期结果,作为Fontan手术的替代方案.
主要方法:
- 在跳动的心脏上进行导电映射,以识别心室隔离患者的His捆.
- 他的捆绑位置与手术前的预测进行了比较.
- 分析了包括心脏阻塞,重新手术和血液动力学在内的结果.
主要成果:
- 在大多数患者中,导电映射显示与预测位置一致.
- 尽管进行了测绘,但在4名患者中发生了完全的心脏阻塞.
- 没有观察到外科手术期间的死亡率或需要单心室息.
- 在随访期间,患者表现出可接受的血液动力学和心室功能.
结论:
- 室腔隔离是对Fontan手术的安全替代方案,可用于接受早期结果的选择患者.
- 术内导电映射可以提高预测心室隔离期间导电位置的精度.
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