Comparison of the effectiveness of surgical treatment of persistent atrial fibrillation using biatrial and left atrial radiofrequency ablation in patients with mitral valve replacement

2018 ◽  
Vol 16 (9) ◽  
pp. 62-68 ◽  
Author(s):  
I. V. Abdulianov ◽  
◽  
M. A. Sungatullin ◽  
I. I. Vagizov ◽  
R. K. Dzhordzhikia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Persistent Atrial Fibrillation

scholarly journals DOES «MAZE» PROCEDURE AFFECT ON HOSPITAL RESULTS OF MITRAL VALVE REPLACEMENT?

2019 ◽  
Vol 26 (2(96)) ◽  
pp. 37-44
Author(s):  
A. Sh. Revishvili ◽  
V. A. Popov ◽  
V. V. Aminov ◽  
M. A. Svetkin
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Mitral Valve Disease ◽  
Left Atrial ◽  
Sinus Node ◽  
Sinus Node Dysfunction ◽  
Atrial Size

Aims.To assess the outcomes of atrial fibrillation (AF) treatment by radiofrequency ablation for patients with mitral valve replacement, the analysis of short-term results of 128 patients was performed.Methods.Mean age of the patients was 56,7±9,6 (29 - 79) years, males - 39, females - 89. Most of the patients had longstanding persistent AF - 81 (63,3%), 28 (21,9%) had persistent AF and 19 (14,8%) - paroxysmal AF. The indications for surgery were: rheumatic mitral valve disease in 105 patients (82%), degerative mitral valve disease - in 21 (16,4%) and with treated infectious endocarditis - in 2 (1,6%). Maze IV procedure was carried out in all cases.Results.Hospital mortality was 0,8% (1 patient). Ten patients (7,9%) required pacemaker implantation. The indications were sinus node dysfunction in 7 patients, bradycardia AF - in 2 patients, AV node dysfunction - in 1. At the discharge 88 patients (69,3%) had a sinus rhythm, 10 (7,9%) - atrial rhythm, pacemaker rhythm with sinus node dysfunction patients - in 4 (3,1%) and AF - in 25 (19,7%). Thus, the rate of freedom from atrial fibrillation was 80,3% (102 patients). The effectiveness of ablation for paroxysmal AF was 100%, persistent - 74,1%, longstanding persistent - 77,8% (p=0,006). To reveal other predictors of freedom from AF at the discharge each ECHO parameter was included in the simple logistic regression analysis. Statistically significant p-value was obtained for the preoperative right atrial size (p=0,005), and close to it for the left atrial size, especially for the index left atrial volume/body surface area (p=0,052).Conclusion.Thus, the radiofrequency ablation is an effective method for treatment of AF in patients undergoing mitral valve replacement. The rate of freedom from AF at the discharge is 80,3%. The predictors of freedom from AF at the discharge are preoperative form of AF and preoperative size of atria.

scholarly journals Surgical Treatment of Atrial Fibrillation with Electhocautery during Mitral Valve Replacement

2016 ◽  
Vol 9 (1) ◽  
pp. 9-12
Author(s):  
Rampada Sarker ◽  
Manoz Kumar Sarker ◽  
Md Ataher Ali ◽  
Abdul Khaleleque Beg
Keyword(s):  
Atrial Fibrillation ◽  
Surgical Treatment ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Block ◽  
Complete Heart Block ◽  
Pulmonary Veins ◽  
Maze Procedure ◽  
Number Of Patients

Background: The Maze procedure is the surgical treatment that can alleviate the three complications of atrial fibrillation- tachycardia, thrombo-embolism and hemodynamic compromise. We attempted ablation of atrial fibrillation with monopolar eletrocautery.Our objective was to evaluate the results of surgical treatment of atrial fibrillation by ablation of the left atrial wallaround the pulmonary veins with conventional electrocautery during mitral valve replacement.Methods:This retrospective observational study was carried out in the Department of Cardiac Surgery, National Institute of cardiovascular diseases, Dhaka, Bangladesh,from January 2014 to February 2016. Ablation of AF with monopolar electrocautery was done during mitral valve replacement. Recurrence of atrial fibrillation, any new arrhythmia, complete heart block, bleeding and perforation was noted during the operation and in postoperative period. Patients were followed up upto three months after the surgery.Results: All the Patients were free from atrial fibrillation after the procedure. At discharge 100 %, after I month 96.2% and after 3 months 92.3 % patient were free from atrial fibrillation. No patients developed complete heart block requiring pace maker and there was no incidence of atrial perforation at the sites of ablation.Conclusion: The surgical treatment of the atrial fibrillation with elcetrocautery during mitral valve replacement is able to reverse this arrhythmia in a significant number of patients during short term follow-up without any complication.Cardiovasc. j. 2016; 9(1): 9-12

Abstract 19678: Safety of Cryoablation of Atrial Fibrillation in the Presence of Mechanical Mitral Valve

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Srinivas Rajsheker ◽  
Pradeep Gujja ◽  
Mehran Attari
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Pulmonary Vein ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Pulmonary Vein Isolation ◽  
Pulmonary Veins ◽  
Standard Of Care ◽  
Fluoroscopic Time

Introduction: Pulmonary vein isolation is an effective therapy for recurrent, symptomatic, drug-refractory atrial fibrillation (AF). Radiofrequency ablation (RFA) has long been the standard of care, while cryoballoon technology has emerged as a feasible approach with promising results in paroxysmal AF. There is risk of catheter entrapment during RFA in patients with mechanical mitral valve and the experience is limited. To the best of our knowledge pulmonary vein isolation (PVI) with cryoablation has never been reported in a patient with a mechanical mitral valve. Case: A 52 year old male presented with symptomatic paroxysmal AF, nonischemic cardiomyopathy biventricular defibrillator, mechanical aortic and mitral valve replacement for rheumatic valvular disease. The patient was highly symptomatic while on sotalol therapy. We proceeded with PVI using cryoablation technology. Procedure: After a single transseptal puncture, a 28 mm cryoballoon catheter and 20mm 8 pole circular recording catheter were advanced into the left atrium. All four pulmonary veins were isolated with the aid of intracardiac echo, fluoroscopy and Ensite 3-D mapping. Caution was maintained to minimize catheter manipulation and to keep the catheters away from the mechanical valvular plane. Discussion: The use of cryoablation for PVI has several potential advantages over radiofrequency ablation including greater improvement in fluoroscopic time and total procedure duration. The risk of prosthetic valve dysfunction due to trauma from ablation catheter, and entrapment of the circular mapping catheter in the mitral valve apparatus represent major concerns when performing PVI in patients with mitral valve replacement, however, less need for manipulation of catheter is an advantage of cryoablation compared to RFA in this case. This case illustrates that cryoablation can be successfully performed in a patient with a prosthetic mechanical mitral valve.

Massive Left Atrial Thrombus After a Left Atrial Surgical Ablation and Bioprosthetic Mitral Valve Replacement

2020 ◽  
Vol 15 (4) ◽  
pp. 389-392
Author(s):  
Mustafa Husaini ◽  
Nishath Quader ◽  
Alan C. Braverman ◽  
Ralph J. Damiano ◽  
Hersh S. Maniar
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Left Atrial Thrombus ◽  
Patient Centered ◽  
Atrial Thrombus ◽  
Surgical Ablation ◽  
Bioprosthetic Mitral Valve

Variability exists regarding the timing and duration of anticoagulation after surgical ablation for atrial fibrillation and bioprosthetic mitral valve replacement (MVR). We report a case in which a patient developed a massive left atrial (LA) thrombus after MVR and left-sided radiofrequency ablation (LRFA). Despite acutely elevated gradients across the bioprosthetic valve, the patient remained asymptomatic and hemodynamically stable; thus, a multidisciplinary, patient-centered discussion was had and the patient was treated successfully with oral anticoagulation.

Successful Surgical Treatment of Dissecting Left Atrial Aneurysm after Mitral Valve Replacement

1985 ◽  
Vol 39 (4) ◽  
pp. 382-384 ◽  
Author(s):  
Kosaku Maeda ◽  
Chojiro Yamashita ◽  
Tsutomu Shida ◽  
Masayoshi Okada ◽  
Kazuo Nakamura
Keyword(s):  
Surgical Treatment ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial

Effect of mitral valve replacement with unipolar radiofrequency ablation of atrial fibrillation

2013 ◽  
Vol 2 (3) ◽  
pp. 213-218
Author(s):  
Gunduz Yumun ◽  
Tamer Turk ◽  
Yusuf Ata ◽  
Derih Ay ◽  
Faruk Toktas ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement

scholarly journals Left Atrial Appendage (LAA) Exclusion in atrial fibrillation patients for mitral valve replacement

2018 ◽  
pp. 19-19
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Vitamin K ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Simple Procedure ◽  
Atrial Appendage ◽  
Thromboembolic Events

Ligation of the left atrial appendage (LAA) during mitral valve replacement (MVR) surgery is a simple procedure which has low operative risk and is not expensive. It can reduce the risk of occurrence of thromboembolic events in combination with the anti-vitamin K.

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