[Left atrial appendage in rheumatic mitral valve disease: The main source of embolism in atrial fibrillation]. / Orejuela izquierda en la enfermedad reumática mitral: principal fuente embolígena en la fibrilación auricular.
Arch Cardiol Mex
; 87(4): 286-291, 2017.
Article
en Es
| MEDLINE
| ID: mdl-27986559
ABSTRACT
OBJECTIVE:
To demonstrate that surgical removal of the left atrial appendage in patients with rheumatic mitral valve disease and long standing persistent atrial fibrillation decreases the possibility of stroke. This also removes the need for long-term oral anticoagulation after surgery.METHOD:
A descriptive, prospective, observational study was conducted on 27 adult patients with rheumatic mitral valve disease and long standing persistent atrial fibrillation, who had undergone mitral valve surgery and surgical removal of the left atrial appendage. Oral anticoagulation was stopped in the third month after surgery. The end-point was the absence of embolic stroke. An assessment was also made of postoperative embolism formation in the left atrium using transthoracic echocardiography.RESULTS:
None of the patients showed embolic stroke after the third post-operative month. Only one patient exhibited transient ischaemic attack on warfarin therapy within the three postoperative months. Left atrial thrombi were also found in 11 (40.7%) cases during surgery. Of these, 6 (54.5%) had had embolic stroke, with no statistical significance (P=.703).CONCLUSIONS:
This study suggests there might be signs that the left atrial appendage may be the main source of emboli in rheumatic mitral valve disease, and its resection could eliminate the risk of stroke in patients with rheumatic mitral valve disease and long-standing persistent atrial fibrillation.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cardiopatía Reumática
/
Fibrilación Atrial
/
Apéndice Atrial
/
Accidente Cerebrovascular
/
Embolia
/
Válvula Mitral
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Female
/
Humans
/
Male
/
Middle aged
Idioma:
Es
Revista:
Arch Cardiol Mex
Asunto de la revista:
CARDIOLOGIA
Año:
2017
Tipo del documento:
Article