Perioperative nursing of modified maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for surgical treatment of permanent atrial fibrillation / 中国实用护理杂志

ABSTRACT

Objective To summarize the perioperative nursing of modified maze procedure using bipolar radiofrequency ablation accompanied with valve replacement for the surgical treatment of heart valve diseases complicated with permanent atrial fibrillation (AF).Methods A total of 55 patients with permanent AF and heart valves diseases were undergone surgical treatment from June 2010 to February 2013 in the Second Affiliated Hospital of Anhui Medical University.Preoperative psychological care and health education were given to patients.The Medtronic Cardioblate 68000 flush bipolar radiofrequency ablation system was applied to all patients.After valve replacement surgery in addition to routine care,rhythm and heart rate monitoring were paid attention to,maintenance of cardiac function,observation of drainage,maintenance of electrolyte balance,observation of pacemaker,observation of amiodarone medication and nursing,as well as health guidance and psychological care were implemented.Results The surgery of 55 patients was successfully completed.The day after surgery,atrial fibrillation in 48 cases turned into sinus rhythm.In all patients,2 of them had suffered Ⅲ degree atrioventricular block after surgery and permanent pacemakers were applicated.There were no cardiac perforation and non-hospital mortality.The average length of stay was(12.5±2.1) d.The mean follow-up was(8.6±3.0) months.87.3％ of patients maintained sinus rhythm,9.1％ in AF rhythm,3.6％ in paced rhythm.Conclusions Modified maze procedure using bipolar radiofrequency ablation is a simple,safe and effective surgical procedure for the treatment of permanent atrial fibrillation.High quality of perioperative nursing is to improve the success rate of surgery and the key to reduce mortality.