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在Redo心脏门手术中同时消去心房动

Yoonjin Kang¹, Dong Jae Han¹, Jae Woong Choi¹

¹Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Korea.

Journal of chest surgery

|November 3, 2025

概括

在重复左侧门手术期间为心房动 (AF) 同时进行手术切除可以改善存活率并减少血栓栓塞事件. 这种手术是高风险患者的可行选择,提供更好的节律结果和长期益处.

科学领域:

心脏病学心脏病学
心脏外科手术心脏外科手术
电子生理学电子生理学

背景情况:

在心脏左侧门手术期间同时进行心房动 (AF) 移除已被确立为低风险患者.
它在重复手术心脏手术中的应用仍然存在争议,因为人们认为风险增加.

研究的目的:

为了评估在接受左侧门重复手术的患者对AF同时进行手术切除的长期临床结果.
为了比较经过AF切除的患者和未经过AF切除的患者之间的生存率,节律控制率和血栓栓塞事件率.

主要方法:

这是一项追溯研究,包括在2000年至2015年期间接受了重复左侧门手术的338名AF患者.
143名患者同时接受了手术切除 (切除组),而195名患者没有 (无切除组).
用治疗权重的逆概率来比较长期结果.

主要成果:

废除组显示出较低早期死亡率的趋势 (3.5%与9.2%,p=0.064).
在5年后,切除组的AF复发明显较低 (12.3%与85.2%,p<0.001).
在中位数为103个月的随访期间,切除组的死亡风险 (aHR 0.495) 和血栓栓事件 (aHR 0.212) 显著降低.

结论:

在复原门手术期间同时进行AF切除与节律结果和生存率的改善有关.
此外,该程序还导致更大程度上免受血栓栓塞事件的影响.
对于接受重复左侧门手术的高风险患者来说,手术切除是合理的考虑.

关键词:

节律失常 (arrhythmia) 是一种心律失常.重新进行心脏手术.通过手术切除,可以进行手术切除.

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