| Objectives Assessing total Thoracoscopic surgical treatment of Radiofrequency catheter ablation in patients with atrial fibrillation and safety of short and middle-term curative effect.Methods Our hospital from April 2010 to March 2012, 16 cases of paroxysmal atria fibrillation in patients, including thirteen patients suffered in paroxysmal AF and three patients suffered in Persistent AF. Two cases(12.5%), atrial fibrillation in patients have previous history of percutaneous catheter ablation treatment failure. There were 10 men and 6 women with a mean age of 60.8±9.2 years. Mean duration of AF was 6.22±2.30 years. A double-lumen endotracheal tube was applied in all folders for single-lung ventilation. Firstly, make the patients stay on the inclined decumbence trend. Right axillaries’ line 4th intercostals space, right axillaries 5th intercostals gap at the front of the torso, right parasternal 4th intercostals legroom were doing a 1.5cm about incisions for surgical treatment operations holes. Axillary the 5th intercostals space at the front of the torso to the right into vats, right axillary line the 4th intercostals maneuver hole.Below the video display, cut heart coated with extraordinary tissue dissector after stripping right substandard pulmonary vein and the inferior vena cava to the oblique sinus,with non-rinse category bipolar radiofrequency ablation clamps right Pulmonary veins,closure of ablation 3 clamp time after time after Radiofrequency catheter ablation.Haemostatic stitch, surgical scuff and drainage canister. Further left Pulmonary veins right 30o bargain, left pulmonary vein ablation maneuver is equivalent to the right, but the divergence is the adding of sinew of Marshall cutting and using harvester stapler in the concave space to get rid of the left atrial appendage. Then let the patients were placed in the right lateral decubitus pose and turned 30°. Procedure was presented in a corresponding style on the right side, however, the difference of opinion with the former is add to annihilation of the left atrial ornament and dissection of the sinew of Marshall.Peri-and postoperative reconnaissance follow-up indicators: General intelligence, complications in patients, before and after 6、12、24、36 months of ECG and 24-hour ambulatory electrocardiographic,echocardiographic,and constitution of life questionnaires.Results All patients underwent successful ablation of pulmonary vein isolation, and 9belongings of left atrial appendage expurgation(56.25%). When the surgery is come to an end, there are 16 patients(100%) resort to sinus rhythm rapidly, 1 patient three days rhythm into atrial fibrillation, in which 15 cases(97.2%) to sinus beat when the serene was discharged. Sinus cadence after cardio version of summarize rate: 14 cases of 6months(87.5%); 12 cases(75%) 12 months; 24 months 13 belongings(81.25%); 36 months 13 cases(81.25%). And follow-up phases of LVEF in patients with LAD compared to the preoperative P<0.05, suggesting that both ameliorate. Apply SF-36 health survey summary to postoperative quality of life in patients with atrial fibrillation follow-up show: each stage compared with preoperative patient follow-up physical health and mental health(P<0.01) improved significantly.Conclusions All atrial fibrillation radiofrequency catheter ablation dealing of videoassisted thoracoscopic is a straightforward, trustworthy, well-organized and cost-effective treatment scheme. Surgical procedures reduces the trauma of surgery and impediments,shortens recovery time after surgical procedure, reduce the operation cost by and large,and be able to meet the patient scratch aesthetic upshot. Taking away of the left atrial appendage to decrease the occurrence of fondle. Postoperative sinus rhythm safeguarding of superiority of existence is significantly improved. |
PDF Full Text Request