The Progress Of Maze Surgery And The Observation Of Myocardial Injury After Cardiac Surgery

1. The Progress of Radiofrequency Modified Maze Procedure Combined with Other Cardiac SurgeryAtrial Fibrillation is the most commonly observed arrhythmia in clinic, which has higher incidence rate on patients who suffer from organic heart disease. The hazards of atrial fibrillation include palpitation, fatigue and systemic embolism, pressing negative impacts on living quality and survival time as well. The surgical treatment of atrial fibrillation is far more efficient than pharmacotherapy and catheter ablation. However, the traditional technology of cutting and sewing owns more difficulties and higher risk, for which it has been replaced gradually by new types of energy, such as radio frequency, cryoablation and microwave. With the development of medicine and the accumulation of clinical experience, the primary path of Maze procedure has been progressing and changing. The first part of this thesis would like to conclude distinguished paths of modified Maze procedure combined with other cardiac surgery through published literature.2. The Observation of Radiofrequency Modified Maze Procedure’s influence on myocardial injuryObjective:To evaluate the degree of myocardial injury made by surgical radiofrequency ablation through observing the modified Maze procedure’s influence on myoglobin, troponin I, creatine kinase-MB and left ventricular ejection fraction (LVEF).Methods:We collected blood samples of 53 patients who has accepted the modified Maze procedure combined with valvular surgery and 53 patients who has accepted only the vavular surgery, then compared the level of myoglobin, troponin I, and creatine kinase-MB of both groups. The LVEF of both groups are compared before and after surgery respectively.Results:The outcomes of myocardial enzymes in the observation group appeared respectively:myoglobin 446.1 ± 162.8μg/L, troponin I 6.6 ± 4.4μg/L, creatine kinase-MB 65.4±23.7μg/L; LVEF before the surgery was 60.6±6.5%, which after the surgery was 60.0±6.4%. By contrast, the results of control group were myoglobin 320.4±123.5μg/L, troponin I 3.7 ±2.2μg/L, creatine kinase-MB 58.4±22.0μg/L; LVEF before the surgery was 62.5±7.2%, which after the surgery was 59.7±7.3%. The level of myoglobin and troponin I in observation group was evidently higher than that in control group (P<0.05). The level of creatine kinase-MB did nor reveal any difference between the two groups (P>0.05).There was no significant difference in LVEF between the observation group and the control group (P>0.05)Conclusions:The modified Maze procedure added myocardial injury to some degree, increasing the content of myocardial enzymes in peripheral blood, while impacting cardiac function less obviously.