ABSTRACT
Objective To investigate the clinical significance of thoracoscopy combined with beating-heart technique to provide a certain reference for selecting clinical operation mode.Methods Forty patients with chronic rheumatic mitral stenosis receiving thoracoscopic mitral valve replacement surgery in the cardiothoracic surgery department of our hospital from September 2012 to September 2015 were included in this study and divided into the experimental group(beating-heart group,20 cases) and control group(arrested heart group,20 cases).The operative time,CPB time,enzymology indicators,RI and operative complications were analyzed and compared between the two groups.Results One case in each group died of postoperative low cardiac output syndrome.Other cases successfully completed the operation without serious operative complications such as low cardiac output syndrome,serious cardiac arrhythmia and air embolism.Two groups had no statistically significant difference in the operation time and time of CPB (P＞0.05),but the ICU staying duration had statistical difference between the two groups(P＜0.05).The levels of CK-MB,cTnI,LDH,TNF-α,IL-6,IL-8 and RI were significantly increased in two groups(P＜0.05),while the levels in the experimental group were significantly lower than those in the control group(P＜0.05).Conclusion Thoracoscopic mitral valve replacement operation with beating-heart may have better protection effect on heart and lung than thoracoscopic arrested-heart mitral valve replacement operation.
ABSTRACT
Objective To investigate the effectiveness of heart valve replacement in the same period of radiofrequency ablation in the treatment of atrial fibrillation.Methods Eighty-six patients with atrial fibrillation underwent heart valve replacement in the same period of bipolar radiofrequency ablation system according to the maze heart valve replacement operation principle.And optimized the operation method.Results No death occurred during operation.The average ablation time was (23 ± 8) minutes with a range of 16-56 minutes.Sinus rhythm of the heart was restored after surgery in all patients (100％).The long-term success rate was 98.8％ (85/86).Conclusion Our optimization of heart valve replacement in the same period of radiofrequency ablation enhanced the success rate of the operation,simplified the procedures,meanwhile it might need widely application clinically.
ABSTRACT
Objective To investigate the feasibility and efficacy of treating atrial fibrillation(AF)in beating heart surgery using bipolar Radiofrequency Ablation(RFA)system. Methods Treating AF in beating heart under normal temperature CBP surgery with bipolar RFA following the circuit of maze operation,2 - 6 times each place,until sinus rhythm appeared,then perform AVR or MVR in the stopped beating heart. Results All 18 cases survived the surgery. Sinus rhythm appeared in all cases. The average treating time was 28 minutes. Conclusions Application of bipolar RFA in the treatment of AF in beating heart is a safe and efficacy method. It is recommended to be applied widely.