Dysrhythmias after atrial surgery in children.
Dysrhythmias after atrial surgery in children.
复制标题
儿童心房手术后心律失常。
DOI：
10.1016/0002-8703(83)90449-0
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发表时间：
1983
影响因子：
4.8
通讯作者：
R. Hardjowijono
中科院分区：
文献类型：
--
作者：
M. Bink;H. Velvis;J. Heide;A. Eygelaar;R. Hardjowijono
对 50 名 Mustard 手术后患者（A 组）和 204 名继发孔房间隔缺损封堵术后患者（B 组）进行回顾性研究，分析术后心律失常并将其与手术因素联系起来。在随访结束时，A 组中有 42% 的患者出现心律失常，而 B 组患者中这一比例为 23%。 A 组晚期死亡率较高 (16%)，与 AF 和 AVJ 显着相关。在 A 组中，心律失常与手术年龄、心脏停跳液的使用、灌注时间和插管类型之间存在显着相关性。在 B 组中，缺损位置与肺静脉引流异常之间存在显着相关性。使用低温而非体外循环进行 ASD 闭合后，心律失常的发生率显着降低。窦房结区域插管和缝合对窦房结的损伤是心房手术后心律失常高发的主要原因。这种高发生率应该成为考虑新型手术的一个因素。
A retrospective study was done in 50 patients after Mustard's operation (group A) and in 204 patients after closure of a secundum atrial septal defect (group B) to analyze the postoperative dysrhythmias and to relate them to surgical factors. Forty-two percent of the patients in group A had dysrhythmias at the end of the follow-up, compared to 23% of group B patients. There was a high late mortality in group A (16%) significantly related to AF and AVJ. In group A a significant correlation was found between dysrhythmias and age at operation, use of cardioplegia, perfusion time, and the type of cannulation. In group B there was a significant relation between the location of the defect and the presence of abnormal pulmonary venous drainage. After ASD closure using hypothermia instead of cardiopulmonary bypass, the incidence of dysrhythmias was significant lower. Damage to the sinus node by cannulation and by suturing in the sinus node area is the main cause of the high incidence of dysrhythmias after atrial surgery. This high incidence should be a factor in the consideration of new types of operations.