Limits...
Chronic Atrial Fibrillation Ablation with Harmonic Scalpel duringMitral Valve Surgery

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.


Related in: MedlinePlus

Results obtained in the immediate postoperative period for patientsundergoing US ablation. AVB=atrioventricular block
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5382896&req=5

f5: Results obtained in the immediate postoperative period for patientsundergoing US ablation. AVB=atrioventricular block

Mentions: Early results showed that 94% of patients undergoing US ablation reversed the rate ofCAF, 86% being in sinus rhythm and 8% in atrioventricular block, which wastransient. Among 6% of the patients, there was no success, there were 4reoperations, and left atrium with severe fibrosis caused by rheumatic fever and/orcalcified (Figure 5). At the end of theprocedure and at the end of CPB, 96% of patients maintained adequate cardiac output,even when CAF was not reversed. There was no reoperation for bleeding in theimmediate postoperative period. In one patient, there was injury of the left atriumwall by US scalpel, corrected by suturing the left atrium. Median operation time was142 minutes with anoxic arrest of 45 minutes. The time to perform the ablation lineswere 12.5 and 14 minutes for the right and left atria, respectively (Table 1).


Chronic Atrial Fibrillation Ablation with Harmonic Scalpel duringMitral Valve Surgery
Results obtained in the immediate postoperative period for patientsundergoing US ablation. AVB=atrioventricular block
© Copyright Policy - open-access
Related In: Results  -  Collection

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

f5: Results obtained in the immediate postoperative period for patientsundergoing US ablation. AVB=atrioventricular block
Mentions: Early results showed that 94% of patients undergoing US ablation reversed the rate ofCAF, 86% being in sinus rhythm and 8% in atrioventricular block, which wastransient. Among 6% of the patients, there was no success, there were 4reoperations, and left atrium with severe fibrosis caused by rheumatic fever and/orcalcified (Figure 5). At the end of theprocedure and at the end of CPB, 96% of patients maintained adequate cardiac output,even when CAF was not reversed. There was no reoperation for bleeding in theimmediate postoperative period. In one patient, there was injury of the left atriumwall by US scalpel, corrected by suturing the left atrium. Median operation time was142 minutes with anoxic arrest of 45 minutes. The time to perform the ablation lineswere 12.5 and 14 minutes for the right and left atria, respectively (Table 1).

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.


Related in: MedlinePlus