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Chronic Atrial Fibrillation Ablation with Harmonic Scalpel duringMitral Valve Surgery

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ABSTRACT

Objective: To evaluate surgical treatment of chronic atrial fibrillation with ultrasoundin patients with mitral valve disease, considering preoperative clinicalcharacteristics of patients undergoing surgical procedure and follow-up inthe immediate postoperative period, in hospital and up to 60 months afterdischarge.

Methods: We studied 100 patients with chronic atrial fibrillation and mitral valvedisease who underwent surgical treatment using ultrasound ablation. Patientdata were reviewed by consulting the control reports, including signs andsymptoms, underlying disease, functional class, hospital stay, surgicalprocedure time, ablation time, immediate complications, and complications atdischarged and up to 60 months later. Actuarial curve (Kaplan-Meier) wasused for the study of permanence without recurrence after 12, 24, 36, 48 and60 months.

Results: 86% of the patients had rheumatic mitral valve disease, 14% had degenerationof the mitral valve, 40% had mitral regurgitation, and 36% had mitralstenosis. Main symptoms included palpitations related to tachycardia bychronic atrial fibrillation (70%), congestive heart failure (70%), andprevious episodes of acute pulmonary edema (27%). Early results showed that94% of the patients undergoing ultrasound ablation reversed the rate ofchronic atrial fibrillation, 86% being in sinus rhythm and 8% inatrioventricular block. At hospital discharge, maintenance of sinus rhythmwas observed in 86% of patients and there was recurrence of chronic atrialfibrillation in 8% of patients. At follow-up after 60 months, 83.8% ofpatients maintained the sinus rhythm.

Conclusion: Surgical treatment of chronic atrial fibrillation with ultrasound concomitantwith mitral valve surgery is feasible and satisfactory, with maintenance ofsinus rhythm in most patients (83.8%) after 60 months of follow-up.

No MeSH data available.


Procedures performed concurrently with the CAF ablation.
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f3: Procedures performed concurrently with the CAF ablation.

Mentions: Operations performed concurrently with the ablation included mitral valve replacementfor bovine pericardial bioprosthesis of Braile Biomédica® (SãoJosé do Rio Preto, SP, Brazil) (69%), mitral valve repair (10%), reoperationwith valve replacement (10%), and associated with tricuspid valve (11%) (Figure 3). In addition to ablation with US, inall patients, additional procedures to surgery included: exclusion of the right andleft atria (90%), reduction in the size of the left atrium through resection and/orplication of the left atrial wall (25%), and thrombectomy (15%) (Figure 4).


Chronic Atrial Fibrillation Ablation with Harmonic Scalpel duringMitral Valve Surgery
Procedures performed concurrently with the CAF ablation.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5382896&req=5

f3: Procedures performed concurrently with the CAF ablation.
Mentions: Operations performed concurrently with the ablation included mitral valve replacementfor bovine pericardial bioprosthesis of Braile Biomédica® (SãoJosé do Rio Preto, SP, Brazil) (69%), mitral valve repair (10%), reoperationwith valve replacement (10%), and associated with tricuspid valve (11%) (Figure 3). In addition to ablation with US, inall patients, additional procedures to surgery included: exclusion of the right andleft atria (90%), reduction in the size of the left atrium through resection and/orplication of the left atrial wall (25%), and thrombectomy (15%) (Figure 4).

View Article: PubMed Central - PubMed

ABSTRACT

Objective: To evaluate surgical treatment of chronic atrial fibrillation with ultrasoundin patients with mitral valve disease, considering preoperative clinicalcharacteristics of patients undergoing surgical procedure and follow-up inthe immediate postoperative period, in hospital and up to 60 months afterdischarge.

Methods: We studied 100 patients with chronic atrial fibrillation and mitral valvedisease who underwent surgical treatment using ultrasound ablation. Patientdata were reviewed by consulting the control reports, including signs andsymptoms, underlying disease, functional class, hospital stay, surgicalprocedure time, ablation time, immediate complications, and complications atdischarged and up to 60 months later. Actuarial curve (Kaplan-Meier) wasused for the study of permanence without recurrence after 12, 24, 36, 48 and60 months.

Results: 86% of the patients had rheumatic mitral valve disease, 14% had degenerationof the mitral valve, 40% had mitral regurgitation, and 36% had mitralstenosis. Main symptoms included palpitations related to tachycardia bychronic atrial fibrillation (70%), congestive heart failure (70%), andprevious episodes of acute pulmonary edema (27%). Early results showed that94% of the patients undergoing ultrasound ablation reversed the rate ofchronic atrial fibrillation, 86% being in sinus rhythm and 8% inatrioventricular block. At hospital discharge, maintenance of sinus rhythmwas observed in 86% of patients and there was recurrence of chronic atrialfibrillation in 8% of patients. At follow-up after 60 months, 83.8% ofpatients maintained the sinus rhythm.

Conclusion: Surgical treatment of chronic atrial fibrillation with ultrasound concomitantwith mitral valve surgery is feasible and satisfactory, with maintenance ofsinus rhythm in most patients (83.8%) after 60 months of follow-up.

No MeSH data available.