[同时节律转换程序Cox-Maze IV在多膜校正中的即时和长期结果]
E P Evseev1, A A Botashev1, I A Aidamirov1
1B.V. Petrovsky Russian Research Center of Surgery, Moscow, Russia.
Khirurgiia
|December 12, 2024
概括
考克斯-马兹IV手术有效地治疗心脏病多膜病患者的心房动,对 Paroxysmal 和持久形式的成功率更高. 早期复发预测因素包括术后节律障碍和长期的心房动.
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
- 医疗器械技术 医疗器械技术
背景情况:
- 心房动 (AF) 是多膜性心脏病 (MVD) 患者的常见并发症.
- 考克斯-马兹IV手术是一种旨在恢复鼻节律的手术干预.
- 评估Cox-Maze IV在MVD患有AF的患者的疗效和长期结果至关重要.
研究的目的:
- 评估Cox-Maze IV手术在患有AF的MVD患者的即时和长期结果.
- 在Cox-Maze IV程序后确定AF复发的预测因子.
主要方法:
- 分析了在2017-2023年期间接受MVD校正和Cox-Maze IV治疗的92名患者.
- 患者有不同类型和持续时间的AF,NYHA功能类III是最常见的.
- 外科手术包括心心动脉置换,心心动脉三管纠正和联合管纠正.
主要成果:
- 住院死亡率为3.3%;长期死亡率为8.7% (3.3%与心脏相关).
- 没有AF的情况为61.4% (发作性),58.1% (持续性) 和32.5% (长期持续性).
- 复发的预测因素包括早期手术后的AF,AF持续时间>60个月,以及左心房扩大.
结论:
- 考克斯-马泽IV在MVD患者中对阳性和持续性AF有效,成功率分别为61.4%和58.1%.
- 这种手术具有较低的心脏起器植入率.
- 早期术后节律障碍和AF持续时间>60个月预测复发;左心房扩大需要考虑心房整形.
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