在Bentall手术后,左心室顶部早发性心室综合体的切除
1Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
JACC. Case reports
|December 3, 2025
概括
在标准方法失败时,跨septal方法在Bentall手术后有效地消除左心室顶部过早心室综合体 (PVCs). 这种技术为具有挑战性的心律失常病例提供了可行的替代方案.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏外科手术 心脏外科手术
背景情况:
- 左心室 (LV) 顶部心律不整,包括早发性心室复合体 (PVCs),造成了切除挑战.
- 在Bentall后的程序中,废除LV顶部PVC很少得到报道,并且在技术上很困难.
研究的目的:
- 为了评估跨septal方法的疗效,在一个有Bentall手术史的患者中切除LV顶部PVCs.
- 介绍一个案例,展示一种新的策略,用于难以消除的心律失常.
主要方法:
- 电生理学测绘在Bentall手术后的药物耐药PVCs患者身上进行.
- 通过逆行性大动脉方法进行初始映射,确定了一个目标部位,但切除只提供了抑制.
- 随后,用反向S曲线导管进行了穿越性靠近,成功地局部化并切除了心律失常的焦点.
主要成果:
- 肺鼻部部位的射频切除只能提供暂时的PVC抑制.
- 跨septal方法成功地确定了一个关键的下大动脉区域进行切除.
- 在3个月的随访期间,PVCs完全消除,没有复发.
结论:
- 标准的逆行性大动脉方法往往是不可行的,为LV峰会映射和Bentall手术后的切除.
- 一个穿越式的方法提供了有效的访问到LV峰会的下椎区域.
- 截面切除是以前经过本塔尔手术的患者的LV峰PVC的安全有效策略.
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