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对 8例心脏血管畸形合并室上性心动过速 (SVT)的患者进行了射频导管消融 (RFCA) ,其中 2例合并布 加氏综合征 ,1例肥厚型梗阻性心肌病 ,1例房间隔缺损 ,1例完全型矫正型大动脉转位 ,2例Ebstein畸形 ,1例二尖瓣重度狭窄。这 8例SVT心内电图与普通病例相比基本相同 ,但因心脏或大血管畸形 ,故操作过程有其特殊性。结果 :上述 8例患者全部消融成功 ,其中SVT合并完全型矫正型大动脉转位患者 2个月后心动过速复发 ,再次消融成功。对合并的心脏血管畸形除 1例Ebstein畸形和 1例完全型矫正型大动脉转位患者未接受进一步治疗外 ,其余均根据适应证进行了相应手术 ,2例布 加氏综合征进行了球囊扩张术 ,1例肥厚型梗阻性心肌病行室间隔化学消融术 ,1例房间隔缺损实施了Amplatzer伞闭术 ,1例Ebstein畸形行房化心室折叠术 ,1例二尖瓣重度狭窄患者行二尖瓣球囊成形术。结论 :合并心脏血管畸形的SVT进行RFCA安全、有效。
Radiofrequency Catheter Ablation (RFCA) was performed in 8 patients with vascular malformations associated with supraventricular tachycardia (SVT), including 2 patients with Budd-Chiari syndrome, 1 hypertrophic obstructive cardiomyopathy, and 1 patient with atrial septum 1 case of complete orthotropic aortic transposition, 2 cases of Ebstein’s deformity and 1 case of severe mitral stenosis. The 8 cases of SVT ECG is basically the same as the common cases, but due to heart or macrovascular malformation, so the operation process has its particularity. Results: All of the above 8 patients were successfully ablated. Among them, SVT complicated with aortic transposition of complete aorta recurred after two months and the ablation was successful again. In addition to 1 case of Ebstein’s malformation and 1 case of complete orthotopic transposition of the great arteries without any further treatment, all the other cases underwent corresponding surgery according to indications. Two cases of Bursts’ syndrome had balloon dilatation One case of hypertrophic obstructive cardiomyopathy underwent chemoembolization, 1 case of atrial septal defect underwent Amplatzer umbrella closure, 1 case of Ebstein’s malformation underwent atrial fibrillation and 1 case of severe mitral stenosis. Cricoid balloon angioplasty. Conclusion: SVT combined with cardiovascular malformations is safe and effective for RFCA.