CAJ | 학술논문

目的：探讨支架植入术治疗房颤射频消融术(RFA)后严重肺静脉狭窄的临床疗效及安全性。方法选择接受房颤RFA 治疗的231例患者进行回顾分析,其中8例患者经 CT 血管成像(CTA)证实术后出现严重肺静脉狭窄。在行血管造影确定病变血管数量、部位及狭窄程度后,在病变部位置入支架,随访观察临床疗效。结果8例患者均顺利完成介入手术治疗,共发现病变血管19支,均植入支架。支架植入术后患者血管狭窄程度、跨狭窄压力阶差、平均肺动脉压及血浆钠尿肽(BNP)水平与支架植入术前相比均显著降低(P <0.01)。最窄处肺静脉内径与支架植入术前相比明显增宽(P <0.01)。术后半年复查 CTA,2例患者共4支血管出现轻-中度再狭窄,给予高压球囊扩张后狭窄消失。扩张术后3个月 CTA 复查,所有患者均未见明显狭窄出现。结论支架植入术治疗房颤射频消融术后严重肺静脉狭窄近期疗效满意,安全可行。
목적：탐토지가식입술치료방전사빈소융술(RFA)후엄중폐정맥협착적림상료효급안전성。방법선택접수방전RFA 치료적231례환자진행회고분석,기중8례환자경 CT 혈관성상(CTA)증실술후출현엄중폐정맥협착。재행혈관조영학정병변혈관수량、부위급협착정도후,재병변부위치입지가,수방관찰림상료효。결과8례환자균순리완성개입수술치료,공발현병변혈관19지,균식입지가。지가식입술후환자혈관협착정도、과협착압력계차、평균폐동맥압급혈장납뇨태(BNP)수평여지가식입술전상비균현저강저(P <0.01)。최착처폐정맥내경여지가식입술전상비명현증관(P <0.01)。술후반년복사 CTA,2례환자공4지혈관출현경-중도재협착,급여고압구낭확장후협착소실。확장술후3개월 CTA 복사,소유환자균미견명현협착출현。결론지가식입술치료방전사빈소융술후엄중폐정맥협착근기료효만의,안전가행。
Objective To investigate the efficiency and safety of stent implantation for severe pulmonary vein stenosis after radiofrequency ablation (RFA)of atrial fibrillation.Methods The clinical date of 231 cases with atrial fibrillation received RFA treatment were analyzed retrospectively.Eight cases were confirmed with severe pulmonary vein stenosis after RFA by CTA.The stents were implanted after angiography.Results All the 1 9 serious pulmonary vein stenosis from the 8 patients were treated stent implantation.The degree of pulmonary vein stenosis,trans-stenotic gradient,mean pulmonary pressure and the level of BNP were significantly decreased after treatment (P <0.01).The minimal diameter of the stenosis was significantly increased compared with preoperative (P <0.01).Six months after stenting,2 patients in 4 pulmonary veins were stenosis.The stenosis was successfully di-lated by repeated interventions with balloon dilation.There was no stenosis appeared in the patients after the repeated interventions with balloon dilation for 3 months.Conclusion Stenting implantation was a feasible and safety method for severe pulmonary vein stenosis after RFA.