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首页> 外文期刊>Journal of cardiac surgery. >Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion.
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Surgical therapy of arrhythmias in single-ventricle patients undergoing Fontan or Fontan conversion.

机译：接受Fontan或Fontan转换的单心室患者的心律失常的外科治疗。

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BACKGROUND: Arrhythmia is detrimental to Fontan hemodynamics. Clinical outcomes among Fontan patients who underwent antiarrhythmic treatment were retrospectively reviewed. METHODS: From January 1996 to January 2007, 182 patients underwent a Fontan procedure, including Fontan conversion. Thirty-nine of the 182 patients showed various arrhythmias pre- or post-Fontan operations, and were treated surgically including Fontan conversion (18 patients) or medically. The authors analyzed the outcomes of arrhythmia treatments retrospectively. RESULTS: Thirty-nine patients (21.4%) showed various arrhythmias, such as atrial flutter, atrial fibrillation, junctional rhythm, sinus node dysfunction, or brady tachyarrhythmia pre- or post-Fontan procedure. Follow-up duration was 13.1 +/- 8.7 years (11 months to 325 months).Atrial flutter and fibrillation only developed in 17 patients who received atriopulmonary connection Fontan, and who were treated by Fontan conversion with concomitant procedures such as Cox-maze procedure (two patients), right-side maze and pacemaker implantation (five patients), right atrial isthmus ablation (four patients), right atrial isthmus cryoablation and pacemaker implantation (five patients), and only pacemaker implantation (one patient). The 21 patients who showed arrhythmia at the time of the Fontan procedure underwent the following procedures concomitantly: right atrial isthmus cryoablation with pacemaker implantation (one patient), right atrial isthmus cryoablation (one patient), or pacemaker implantation (nine patients). The remaining 10 patients, who showed junctional rhythm, sinus bradycardia, or intermittent ectopic beats, were managed medically. There were two late mortalities due to protein-losing enteropathy. As a result, 33 patients (89.2%) maintained atrioventricular synchrony, 19 in sinus rhythm and 14 supported by a DDD-type pacemaker. The remaining four patients (10.8%) showed persistent junctional rhythm with a stable hemodynamic status. CONCLUSIONS: The various arrhythmias in Fontan patients were well controlled by aggressive surgical management.
机译：背景：心律失常对Fontan的血流动力学有害。回顾性地回顾了接受抗心律不齐治疗的Fontan患者的临床结局。方法：从1996年1月至2007年1月，共182例患者接受了Fontan手术，包括Fontan转换。 182例患者中有39例在Fontan术前或术后表现出各种心律不齐，并接受了包括Fontan转换在内的手术治疗（18例）或进行了医学治疗。作者回顾性分析了心律不齐治疗的结果。结果：39例患者（占21.4％）表现出各种心律失常，例如心房扑动，房颤，交界性节律，窦房结功能障碍或丰坦术前或术后心律失常性心律失常。随访时间为13.1 +/- 8.7年（11个月至325个月）。只有17例接受房肺连接Fontan并接受Fontan转化治疗并伴有Cox-迷宫手术的患者出现房扑和纤颤。 （两名患者），右侧迷宫和起搏器植入术（五位患者），右房峡峡消融术（四位患者），右房峡峡部冷冻消融术和心脏起搏器植入术（五位患者），仅心脏起搏器植入术（一名患者）。在Fontan手术时表现出心律不齐的21例患者，同时进行了以下手术：右心房峡部冷冻消融并植入起搏器（一名患者），右心房峡部冰冻消融（一名患者）或起搏器植入（九名患者）。其余10例表现出交界性节律，窦性心动过缓或间歇性异位搏动的患者接受了药物治疗。由于蛋白质丢失性肠病，有两个晚期死亡率。结果，有33例患者（89.2％）保持房室同步性，窦性心律19例，DDD型起搏器支持14例。其余四名患者（10.8％）表现出持续性交界性节律，血液动力学状态稳定。结论：积极的外科手术治疗可以很好地控制Fontan患者的各种心律失常。

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