scholarly journals Macro-reentrant atrial tachycardia after tricuspid or mitral valve surgery: is there difference in electrophysiological characteristics and effectiveness of catheter ablation?

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xin-hua Wang ◽  
Ling-cong Kong ◽  
Tian Shuang ◽  
Zheng Li ◽  
Jun Pu
Keyword(s):  
Mitral Valve ◽  
Left Atrial ◽  
Three Dimensional ◽  
Clinical Effectiveness ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Right Atrial ◽  
Free Wall ◽  
One Year ◽  
The One

Abstract Background Macro-reentrant atrial tachycardias (MATs) are a common complication after cardiac valve surgery. The MAT types and the effectiveness of MAT ablation might differ after different valve surgery. Data comparing the electrophysiological characteristics and the ablation results of MAT post-tricuspid or mitral valve surgery are limited. Methods Forty-eight patients (29 males, age 56.1 ± 13.3 years) with MAT after valve surgery were assigned to tricuspid valve (TV) group (n = 18) and mitral valve (MV) group (n = 30). MATs were mapped and ablated guided by a three-dimensional navigation system. The one-year clinical effectiveness was compared in two groups. Results Nineteen MATs were documented in TV group, including 16 cavo-tricuspid isthmus (CTI)-dependent AFL and 3 other MATs at right atrial (RA) free wall, RA septum and left atrial (LA) roof. Thirty-nine MATs were identified in MV group, including15 CTI-dependent AFL, 8 RA free wall scar-related, 2 RA septum scar-related, 8 peri-mitral flutter, 3 LA roof-dependent, 2 LA anterior scar-related, and 1 right pulmonary vein-related MAT. Compared with TV group, MV group had significantly lower prevalence of CTI-dependent AFL (38.5% vs. 84.2%), higher prevalence of left atrial MAT (35.9 vs.5.3%) and higher proportion of patients with left atrial MAT (40 vs. 5.6%), P = 0.02, 0.01 and 0.01, respectively. The acute success rate of MAT ablation (100 vs. 93.3%) and the one-year freedom from atrial tachy-arrhythmias (72.2 vs. 76.5%) was comparable in TV and MV group. No predictor for recurrence was identified. Conclusion Although the types of MATs differed significantly in patients with prior TV or MV surgery, the acute and mid-term effectiveness of MAT ablation was comparable in two groups. Trial registration: This study was registered as a part of EARLY-MYO-AF clinical trial at the website ClinicalTrials. gov (NCT04512222).

How to Do It: Importance of Left Atrial Side Retraction in Robotic and Minimally Invasive Mitral Valve Surgery

2008 ◽  
Vol 11 (5) ◽  
pp. E270-E271 ◽  
Author(s):  
Norihiko Ishikawa ◽  
You Su Sun ◽  
L. Wiley Nifong ◽  
Go Watanabe ◽  
W. Randolph Chitwood
Keyword(s):  
Mitral Valve ◽  
Minimally Invasive ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery

Left Atrial Dissection: An Unusual Complication of Mitral Valve Surgery

2007 ◽  
Vol 24 (4) ◽  
pp. 443-444 ◽  
Author(s):  
Sonal Jani ◽  
Susan Hecht ◽  
Keith Leibowitz ◽  
Marvin Berger
Keyword(s):  
Mitral Valve ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Unusual Complication ◽  
Left Atrial Dissection

A Systematic Review and Meta-analysis of Transeptal vs Left Atrial Approach for Mitral Valve Surgery

2020 ◽  
Vol 4 (sup1) ◽  
pp. 121-122
Author(s):  
Amer Harky ◽  
Arish Noshirwani ◽  
Dimitrios Pousios ◽  
Andrew D. Muir
Keyword(s):  
Systematic Review ◽  
Mitral Valve ◽  
Left Atrial ◽  
Meta Analysis ◽  
Mitral Valve Surgery ◽  
Valve Surgery

Left Atrial Roof: An Alternative Minimal Approach for Mitral Valve Surgery

2012 ◽  
Vol 7 (6) ◽  
pp. 417-420 ◽  
Author(s):  
Giampiero Esposito ◽  
Giangiuseppe Cappabianca ◽  
Samuele Bichi ◽  
Davide Patrini ◽  
Pasquale Pellegrino
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Mitral Repair ◽  
Venous Cannula ◽  
Surgical Incisions ◽  
Effective Option

Objective The most common surgical incisions to expose the mitral valve include a paraseptal left atriotomy or a transeptal biatrial approach. Both techniques are normally performed through a full sternotomy and bicaval cannulation. We report our experience with an alternative incision to expose the mitral valve using the left atrial roof (LAR) through a complete sternotomy or a J-shaped upper ministernotomy. Methods Between 2007 and 2011, a total of 512 patients underwent mitral procedures using the LAR approach. A J-shaped ministernotomy was performed in 189 patients, and 61 of these had concomitant aortic valve/root procedures. A standard sternotomy was performed in 323 patients, and 126 of these had concomitant aortic valve/root procedures. The repair rate in patients with mitral regurgitation was 398 of 460 (86.5%). Results In-hospital mortality was 2.3%. An adjunctive pericardial patch to repair the LAR was necessary in 1.9% of patients. A permanent pacemaker was necessary in 3.1% of patients. Four-year survival rate was 91% ± 4.2%. In patients who underwent mitral repair, 4-year freedom from mitral regurgitation greater than 2 was 97.4%. Conclusions The LAR approach is a safe and effective option to perform mitral valve surgery. The limited extension of this incision and the possibility to use a single venous cannula make this approach suitable for minimally invasive isolated mitral valve procedures, whereas the proximity of the LAR to the aortic root makes this approach particularly attractive for combined mitroaortic procedures through a ministernotomy.

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