ONE-STAGE APPLICATION OF MITRAL VALVE CORRECTION, SURGICAL RADIOFREQUENCY ABLATION AND LEFT ATRIAL ATRIOPLASTY

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Abstract


Objective: Our aim was to evaluate sinus rhythm restoration and its failure predictors after one-stage application of surgical radiofrequency ablation, left atrial reduction and mitral valve correction. Methods: This is a prospective longitudinal cohort study with historical controls. Patients were divided into 2 groups according to the performed type of operation — the main group included patients undergone one-stage mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty (n =47); and the control group consisted of patients undergone only mitral valve correction (n =76). Surgical radiofrequency ablation was performed under the scheme Maze-IV. Left atrial atrioplasty procedure was performed according to echocardiography data: if in women LA antero-posterior dimensions were more than 4.7 cm and in men more than 5.2 cm. Results: The study included 123 patients. In the main group (age of the patients 61.0±9.1 years, 55% male) sinus rhythm restoration was observed in 32 (68%) patients during the early postoperative period, but at the time of discharge it reduced to 19 (40%), but in 6 months it increased up to 37 (78%), and in 36 months sinus rhythm already was detected in 40 (85%) patients. At the same time, during the early postoperative period in the control group (patients aged 59.0±11.0 years, 61% male) only 31 (40%) of patients had sinus rhythm, in 6 months it was detected in 11 (14%) cases, and in 36 months sinus rhythm – only in 28 (37%) patients. Predictors of atrial fibrillation recurrence were revealed: valve disease continuance <4 years (p =0.017) and atrial fibrillation history <3 years (p =0.029). Conclusion: One-stage performing of mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty restores and maintains more regular sinus rhythm, even in presence of atrial fibrillation recurrence predictors.

 

 


S. D. Joshibayev

Research Clinical Center of Cardiac Surgery and Transplantation, Taraz city, Kazakhstan

Author for correspondence.
Email: dseit@list.ru

Kazakhstan

доктор медицинских наук, профессор, директор Научно-клинического центра
кардиохирургии и трансплантологии
Адрес: 080000, Республика Казахстан, Тараз, ул. Абая, д. 196/1, тел.: +7 (7262) 54-28-00

B. A. Bolatbekov

Research Clinical Center of Cardiac Surgery and Transplantation, Taraz city, Kazakhstan
International Kazakh-Turkish University, Turkestan city, Kazakhstan

Email: bekamaika@mail.ru

Kazakhstan

врач-кардиохирург, старший научный сотрудник кардиохирургического отделения
Научно-клинического центра кардиохирургии и трансплантологии, докторант международного казахско-турецкого университета
Адрес: 080000, Республика Казахстан, Тараз, ул. Абая, д. 196/1, тел.: +7 (7262) 54-28-00

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