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目的:探讨经主动脉逆行至二尖瓣环房侧消融左侧旁路的可行性。方法:左侧旁路消融病例159例,消融导管均经主动脉逆行置入,于二尖瓣环房侧或室侧进行消融。根据消融部位分组,记录手术时间、曝光时间、放电功率、放电次数等参数,并进行对比研究。结果:所有病例均获得了手术成功,其中2例首次消融后复发,而接受了再次手术,故共完成了161次手术,消融了165条左侧旁路。其中109条旁路(66.1%)于房侧消融成功。比较房侧及室侧消融病例各项参数,前者最大放电功率大于后者(P<0.01),而手术时间、曝光时间及放电次数均差异无统计学意义(P>0.05)。2例复发病例首次手术时均于室侧消融,再次手术时于房侧消融,未再复发。结论:经主动脉逆行至二尖瓣环房侧消融左侧旁路这一方法可提高左侧旁路消融成功率及降低复发率,并在多数情况下可取代经房间隔穿刺消融的方法。
Objective: To investigate the feasibility of retrograde aortic retrograde to the left side of the atrial mitral ablation. Methods: A total of 159 cases of left bypass ablation were treated with retrograde ablation of the aortic cannula. The ablation catheter was ablated in the mitral annular or lateral ventricle. Grouping according to the ablation site, recording operation time, exposure time, discharge power, discharge times and other parameters, and comparative study. RESULTS: All patients underwent successful surgery. Two of them underwent reoperation after initial ablation, and underwent reoperation. As a result, 161 surgeries were performed and 165 left bypass ablations. 109 bypass (66.1%) ablation on the side of the room was successful. Comparison of atrial and ventricular ablation cases of the parameters, the former maximum discharge power is greater than the latter (P <0.01), while the operation time, exposure time and the number of discharge was no significant difference (P> 0.05). Two cases of recurrent cases in the first operation were ablation on the lateral ventricle, reoperation in the ablation side of the room, no recurrence. CONCLUSIONS: The retrograde aortic approach to the left circumflex of the mitral annulus ablation improves the success rate of left bypass ablation and reduces the recurrence rate, and in most cases may replace the transabdominal puncture and ablation method.