房颤手术和迷宫手术
迷宫手术是一种治疗手术 atrial fibrillation (AFib or AF), a type of irregular heartbeat.
什么是迷宫程序?
The maze procedure creates scars in strategic places in the atria (the heart’s 两个上院). This creates a “maze” of scar tissue that the surgeon creates with the application of cold energy (cryoablation). The maze can prevent faulty electrical signals from causing AFib.
A maze procedure can be done during open-heart surgery for another heart condition. Or it can be a minimally invasive procedure (sometimes called a minimaze) performed with smaller incisions.
A maze procedure can correct AFib, improving symptoms and quality of life.
在手术过程中，外科医生也 关闭左心房附件 — a finger-size outpouching of the left atrium that is commonly the source of blood clots that occur from stagnant blood when a person is in AFib. Closing the left atrial appendage has been shown to decrease the risk of stroke by more than 30%.
The maze procedure is successful in treating AFib in 60%–70% of patients, who can often stop taking blood thinners several months after the procedure.
为什么我可能需要心房纤颤迷宫手术?
AFib can cause several symptoms, such as chest pain and shortness of breath. It also may lead to complications such as blood clots and stroke. 所以，诊断和治疗它很重要.
There are several additional ways to treat atrial fibrillation, 包括:
The maze procedure is used to treat people who don’t respond to other treatments or can't tolerate them. It's also a good option for people who need open-heart surgery for additional reasons (for example, to treat mitral valve disease) because both procedures can be performed at the same time.
The maze procedure can correct AFib, ease symptoms and prevent complications. Your doctor will help you decide whether the procedure or another option is right for you.
我该如何为迷宫手术做准备?
To make sure you are healthy enough for this open-heart surgery, you may need some tests:
- 血液测试
- 胸部x光片
- Electrocardiogram, also called an ECG or EKG, to assess the heart rhythm
- Echocardiogram, or echo, to assess heart structure and function
如果你要做迷宫手术, your surgeon will give you specific instructions, 包括:
- Avoid eating or drinking anything after midnight the day of surgery.
- 手术前戒烟.
- Stop taking certain medications beforehand, particularly blood thinners.
约翰霍普金斯的心房纤颤治疗
- 心脏病专家会监督你的护理.
- 最新的研究为治疗提供了信息.
- Care available throughout the Baltimore and Washington, D.C.，都市区.
迷宫过程中会发生什么?
Maze procedures vary depending on the condition of patients and other procedures happening at the same time. 但一般来说，手术会持续几个小时.
手术小组将:
- Shave the skin where the surgery will occur, if needed.
- Give you anesthesia so that you sleep deeply and experience no pain during the operation.
- Make an incision (cut) down the middle of your chest and separate your breastbone.
- Connect you to a heart-lung machine (cardiopulmonary bypass), which will do the work of your heart and lungs during the procedure.
- Use cryoablation to make scar lines in the left and right atria. The surgeon may also close the left atrial appendage.
- 把你从心肺机上拿下来, 把你的胸骨接起来, 用针或订书钉缝合切口.
迷宫手术的风险是什么?
Complications can occur after any type of surgery, and they are more likely in people who:
- 是老的
- 都超重了
- 患有多种疾病
- 烟
Your surgeon will talk to you about your risks and how to reduce them.
Complications after the maze procedure are rare but may include:
- 出血
- Blood clots, which might lead to a stroke or heart attack
- 需要永久性心脏起搏器
- 麻醉并发症
- 无法控制异常的节律
- 感染
- 肾功能衰竭
- 其他心律失常
迷宫手术后会发生什么?
手术消融后, 你会被转移到恢复室, 你会在哪里从麻醉中醒来. You will be a little sore, but you shouldn’t feel severe pain.
You may have a tube in your throat to help you breathe. You also might have a tube in your chest to drain extra fluids. The tubes are usually removed within two days after surgery.
您的医疗团队将:
- Monitor your heart rate and other vital signs through machines at your bedside
- Teach you breathing 锻炼s to help remove fluids that can collect in the lungs during surgery
- Give you only liquids to drink at first, then slowly add food you can eat
- Encourage you to sit in a chair and walk with help during the first day or two
- Monitor your pain and give you medications and strategies to manage it
- 当你恢复的时候取出管子
Most people stay in the hospital for a few days after a maze procedure. 应该有人开车送你回家.
你出院后
- 在接下来的几个星期里不要提任何重物.
- 遵循所有恢复说明, 包括药物方面, 锻炼, 饮食, 伤口护理和驾驶.
- 家里有人帮忙吗.
- See the surgeon in seven to 10 days for a follow-up appointment and for removal of stitches or staples.
- You will slowly recover your strength over several weeks.
心房颤动手术后的前景如何?
The maze procedure is usually successful — it corrects AFib and prevents stroke in 60%–70% of patients. 然而，房颤可能会复发.
Talk to your doctor about how often you should have follow-up appointments to monitor your health after AFib surgery.
