迷宫手术治疗房颤

消融手术是治疗房颤最有效的方法,与经典迷宫手术结合,超过90%的房颤患者的心律失常可以得到消除.这种手术方法虽然安全,但是较为复杂,只有为数较少的外科医生采用.然而,随着对房颤的发病机制的深入理解以及消融技术的进步,外科医师不再采用肺静脉消融、左房切口及左心耳切除的方法（迷宫I手术）.直视下进行手术操作,最大限度地降低了肺静脉和纵膈组织损伤的风险.大多数消融手术与二尖瓣手术同时进行,进行二尖瓣瓣膜修复同时行房颤消融,可使患者摆脱终生抗凝的困境.胸腔镜手术设备的发展现在已经达到可以与直视手术相同的效果,利于扩大心外膜消融径线及对孤立性房颤左心耳的切除,并且适用于无需进行其他心脏手术的房颤患者.

Surgical Maze ablation curing atria fibrillation

Surgical ablation of atria fibrillation （AF） is the most effective means of curing this arrhythmia, with the Classic Maze procedure eliminating AF in more than 90% of patients. A complex but safe operation, the Maze procedure has been applied by relatively few surgeons. However, recent advances in the understanding of the pathogenesis of AF and development of new ablation technologies enable surgeon stop perform pulmonary vein ablation, create linear left atrial lesions, and remove the left atrial appendage. Lesions are created under direct vision, minimizing the risk of damage to the pulmonary veins and adjacent mediastinal structures. Most surgical ablation procedures have been performed in conjunction with mitral valve surgery, the combination of mitral valve repair and cure of AF enabling patients to avoid lifelong anticoagulation. Recently developed surgical instrumentation now enables thoracoscopic and keyhole approaches, facilitating extension of epicardial AF ablation and excision of the left atrial appendage to patients with isolated AF and no other indication for cardiac surgery.