Dissertation
Dissertation > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Heart disease > Rheumatic heart disease

Clinical Research on Left Atrial Reduction and Modified Maze in the Treatment of Chronic Atrial Fibrillation in Rheumatic Heart Disease

Author ZhouYaJun
Tutor XuJianJun
School Nanchang University
Course Surgery
Keywords Left atrial volume reduction surgery Modified maze procedure Atrial fibrillation Rheumatic heart disease Brain natriuretic peptide
CLC R541.2
Type Master's thesis
Year 2010
Downloads 31
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Objective To evaluate left atrial volume reduction surgery (left atrial reduction, LAR) and modified maze procedure for the treatment of rheumatic heart disease (RHD ) associated with chronic atrial fibrillation (CAF) , the clinical effect . Methods 60 patients with left atrial volume index ≥ 55mL/m2 of rheumatic heart disease with CAF patients , the implementation of the mitral valve replacement with modified maze procedure , modified maze procedure improved III maze procedure based , which over the same period plus row left atrial volume reduction surgery (LAR ) , 30 cases , LAR surgery not add lines 30 cases of the control group . Application electrocardiogram and echocardiography in cardiac electrical activity of the two groups of patients before and after surgery , NYHA left atrium inside diameter ( LAD ) , left atrial volume index ( LAVI ) , left ventricular ejection fraction (LVEF), cardiothoracic ratio (C / T) and dynamic changes of plasma brain natriuretic peptide (BNP) . The follow-up period of 1 year. Results LAR group and a control group to restore and maintain sinus rhythm , respectively, 76.6% and 50 % ( P lt; 0.01 ) , improvement of cardiac function levels were 2.0 ± 0.6 and 1.1 ± 0.5 (P lt; 0.01), postoperative LAD 40 ± 0.8mm mm and 59 ± 1.2mm ( P lt; 0.05 ) , LAVI 52.45 ± 8.35 ml/m2 and 66.45 ± 12.42 ml/m2 ( P lt; 0.05 ) , LVEF were 0.66 ± 0.08 and 0.56 ± 0.12 (P lt; 0. 05), C / T were 0.56 ± 0.10 and 0.64 ± 0.11 ( P lt; 0.05 ) . 6 months after plasma BNP was 170.35 ± 62.15 and 628.57 ± 212.35 (P lt ; 0.05 ) . Conclusion CAF in patients with rheumatic heart disease with giant left atrium and left atrial volume reduction surgery a heart valve replacement surgery and modified maze procedure for the same period plus line , the ratio can improve the cure rate and long-term maintenance of AF to sinus rhythm ; while the left atrium active contractile function room further improvement , and can significantly reduce postoperative plasma brain natriuretic peptide levels .

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