心房迷宫术

迷宫术是用于治疗心律不齐(心房颤动)的手术。外科医生使用手术刀或递送热能或冷能的器械在心脏上腔(心房)形成瘢痕组织图案(迷宫)。

瘢痕组织会阻滞电传导,因此由其形成的迷宫会干扰导致心房颤动的杂散心脏电信号。

目的

迷宫术可以纠正房颤并提高房颤患者的生活质量。

如果您的房颤(A-fib)在使用药物或其他医疗程序后没有改善,或者如果治疗后 A-fib 复发,医务人员可能会建议进行迷宫术。如果您将进行另一项心脏手术,如冠状动脉搭桥手术或瓣膜修复术,可以同时进行迷宫术。

可能出现的情况

在确定迷宫术是否适合您之前,医务人员很可能会对您进行多项检查,以获取有关您心脏健康状况的更多信息。如果安排您进行手术,医疗团队会告诉您如何做准备以及携带哪些物品入院。

术中

进行迷宫术时,医生通常会使用药物使您处于睡眠状态(全身麻醉),还会为您接上人工心肺机。

在迷宫术中,外科医生会在您的胸部做一个切口,进入您的心脏上腔。外科医生会使用热能(射频能量)、极冷能(冷冻消融)或手术刀在心脏组织上切几个精确的切口。这些切口会形成线条图案(迷宫),最终成为瘢痕。瘢痕组织可阻断导致心律不齐的异常电信号。

使用人工心肺机期间,医生也可能进行其他需要的心脏手术,如瓣膜修复或起搏器安置。

有些接受迷宫术的患者可能会接受机器人辅助的导管消融手术治疗。这项手术也可以通过外科手术和经导管干预相结合的方式进行。这些略有不同的方法有时称为小型迷宫术或复合方法。

Surgical maze

This is a type of heart surgery. You are put on a heart-lung machine. The machine keeps blood and oxygen flowing through your body.

Another name for surgical maze is the Cox-maze procedure. It's the preferred AFib treatment in those who need another heart surgery, such as heart valve surgery.

Surgical maze may be done in two ways:

  • Open-heart surgery. The surgeon makes a long cut in the chest through the breastbone to reach the heart. This is called a sternotomy. Then the surgeon uses a scalpel, heat energy or cold energy to create the maze.
  • Minimally invasive robotic surgery. Very small cuts and robotic technology are used to reach the heart. With this method, only heat energy or cold energy is used to create the maze pattern.

Surgeons can do other heart treatments or place a pacemaker, if needed, during the procedure.

Catheter ablation maze

This treatment uses thin, flexible tubes called catheters. The surgeon makes a cut to reach a blood vessel, usually in the groin area. The catheters go into the blood vessel. Then, they are moved to the appropriate area in the heart. Sensors on the end of the catheters give off heat or cold energy. The energy is used to create a pattern of scar tissue that blocks or redirects the faulty heart signals.

Mini-maze

Sometimes both surgery and catheter methods are used to create the maze. This is called a mini-maze procedure or a hybrid approach.

结果

大多数心房颤动患者在接受迷宫术治疗后,生活质量有所改善。但这种不规律的心跳有可能会复发。如果发生这种情况,您可能需要服用药物或再次进行迷宫术。

如果您在外科迷宫术后出现心律缓慢,医务人员可能会建议您植入起搏器。