Efficacy of Cut-and-Sew Surgical Ablation for Atrial Fibrillation in Patients With Giant Left Atria Undergoing Mitral Valve Surgery: A Propensity-Matched Analysis.
Semin Thorac Cardiovasc Surg
; 31(4): 796-802, 2019.
Article
em En
| MEDLINE
| ID: mdl-31077808
ABSTRACT
Surgical management for patients with long-standing persistent (LSP) AF and giant left atria (GLA) associated with mitral valve diseases remains a challenge. We aimed to assess the efficacy of the cut-and-sew maze procedure (CSM) in this subgroup of patients, in terms of maintenance of sinus rhythm (SR), atrial function, and to identify the operative risks of this procedure. A total of 229 patients with LSP-AF underwent CSM at our institution from December 2013 to October 2017. Patients were divided into 2 groups based on LA diameter NGLA group (<65 mm, nâ¯=â¯171), GLA group (≥65 mm, nâ¯=â¯58). Patients with GLA were propensity score matched to patients without GLA resulting in 45 pairs of patients. Early death occurred in 1 (2.2%) in GLA group and no deaths in NGLA group (Pâ¯=â¯0.315). Early complications did not differ significantly between the 2 groups. The GLA group showed similar rates of SR on and off antiarrhythmic drugs compared with NGLA group at 2 years (86.36% vs 93.9%, Pâ¯=â¯0.338; 81.82% vs 90.91%, Pâ¯=â¯0.322). At 2 years, LA contraction was comparable between patients with and without GLA (81.81% vs 90.9%, Pâ¯=â¯0.322). Right atrial contraction recovery rate was 96% in NGLA group, and 86.36% in GLA group (Pâ¯=â¯0.138). Concomitant CSM is effective and feasible for restoration of SR and atrial contraction, for patients with LSP-AF and GLA associated with mitral valve diseases with acceptable operative risks.
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Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Fibrilação Atrial
/
Suturas
/
Técnicas de Sutura
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Implante de Prótese de Valva Cardíaca
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Criocirurgia
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Anuloplastia da Valva Mitral
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Doenças das Valvas Cardíacas
/
Valva Mitral
Tipo de estudo:
Etiology_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Aged
/
Female
/
Humans
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Male
/
Middle aged
Idioma:
En
Revista:
Semin Thorac Cardiovasc Surg
Assunto da revista:
ANGIOLOGIA
/
CARDIOLOGIA
Ano de publicação:
2019
Tipo de documento:
Article