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

Mitral valve replacement with or without a concomitant Maze procedure in patients with atrial fibrillation

Heart ◽  
2010 ◽  
Vol 96 (14) ◽  
pp. 1126-1131 ◽  
Author(s):  
J. B. Kim ◽  
M. H. Ju ◽  
S. C. Yun ◽  
S. H. Jung ◽  
C. H. Chung ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Maze Procedure

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.

scholarly journals Himalayan Fibrillatory Waves in Juvenile Rheumatic Mitral Stenosis

2021 ◽  
Author(s):  
Mohamed Kassim Akheela ◽  
A. Shaheer Ahmed
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Oral Anticoagulation ◽  
Mitral Stenosis ◽  
Large Amplitude ◽  
Maze Procedure ◽  
Rheumatic Mitral Stenosis

AbstractAn 18-year-old girl, a known case of rheumatic mitral stenosis, presented with dyspnea and palpitations. Electrocardiogram was done, which revealed atrial fibrillation and a large amplitude atrial fibrillatory wave, which was more than the voltage of R wave V1, a finding which is quite uncommon. Echocardiography revealed a large left atrium which was 80 mm in diameter. The patient was started on oral anticoagulation and referred for mitral valve replacement with maze procedure.

Abstract 18019: Successful Surgical Management of Severely Symptomatic Hypertrophic Cardiomyopathy Patients With Minimal Septal Hypertrophy

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Raabia N Ahmad ◽  
Barry J Maron ◽  
Ethan J Rowin ◽  
Tammy S Haas ◽  
Joseph A Dearani ◽  
...  
Keyword(s):  
Hypertrophic Cardiomyopathy ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Heart Block ◽  
Valve Repair ◽  
Outflow Obstruction ◽  
Septal Wall ◽  
Septal Hypertrophy ◽  
Surgical Myectomy

Background: Marked septal hypertrophy is considered a requirement for effective myectomy in obstructive hypertrophic cardiomyopathy (HCM), with mitral valve replacement recommended as the alternative strategy in patients with minimal hypertrophy. However, it remains uncertain whether relief of obstruction can be effectively abolished without mitral valve replacement in patients with minimal septal wall thickening. Methods: Of 500 patients who underwent surgical myectomy from 2004 to January 2014, 21 (4.2%) were identified with a maximum LV wall thickness ≤ 15mm and constitute the study cohort. Results: All 21 patients (56 ± 10 years old; 62% male) were followed for advanced heart failure symptoms refractory to drug therapy with a maximal septal wall thickness of 13.6 ± 1.7 mm (range: 10-15 mm; ≤ 12 mm in 5 patients). Outflow obstruction ≥ 30 mmHg due to mitral valve-septal contact was present after exercise in 17 of 21 patients (range: 50-150 mmHg), and under resting conditions in 4 patients (range: 30-65 mmHg). In all patients, surgical relief of obstruction consisted of muscular resection of the basal septum with revision of abnormal and apically displaced papillary muscles, which were judged intraoperatively to be contributing to obstruction. In addition, in 10 patients (47%) myectomy alone was not sufficient to relieve obstruction due to the limited opportunity for septal reduction and adjunctive mitral valve repair was performed to shorten an elongated anterior leaflet. No patient required mitral valve replacement or incurred a ventricular septal defect. Post-operatively, 4 patients developed complete heart block requiring permanent pacemaker (1 patient with pre-operative right bundle branch block) and 1 had a cerebrovascular event. At most recent follow up 18 ± 19 months post-myectomy, septal thickness was reduced to 10 ± 2 mm, no patient had an outflow gradient at rest or with provocation, and all patients were alive with the majority asymptomatic (class I: n=13; 62% and class II n=8; 38%). Conclusion: In patients with minimal septal hypertrophy, outflow obstruction can be effectively abolished with surgical myectomy and adjunctive mitral valve repair with a small increased risk of heart block, but without the need for mitral valve replacement.

scholarly journals Retrospective Study of the Outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair in Ain Shams University

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A M A Elfeky ◽  
M M A Fadala ◽  
O A Abdelhameed ◽  
R M R Khorshid
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Tricuspid Valve ◽  
Mitral Valve Disease ◽  
Valve Disease ◽  
Morbidity And Mortality ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Number Of Patients

Abstract Background Rheumatic mitral valvular disease is more common than degenerative mitral valve disease. Mitral valve repair is not possible in large number of patients because of rheumatic cicatrized subvalvular mitral valve disease. The prosthetic mitral valve replacement is commonly performed in our center. Objective The aim of the study was to evaluate and assess the short outcome of Mitral Valve Replacement with or without Tricuspid Valve Repair. Patients and Methods This study was done in department of Cardiothoracic surgery, Faculty of Medicine at Ain Shams university, after approval of the local ethical committee from 2015 to 2016.The inclusion criteria includes All gender, All age, Primary Mitral valve replacement for severe Mitral valve disease of Rheumatic origin with or without Tricuspid Valve Repair and Primary Mitral valve replacement for severe Mitral valve disease of Degenerative origin with or without Tricuspid Valve Repair and the exclusion criteria includes concomitant coronary artery bypass graft surgery or other cardiac operations or infective endocarditis and Patients with chronic liver, kidney and parenchymal pulmonary disease. Results This study included one hundred and seventy- seven (177) patients; One hundred and thirty one (131) patients did Mitral Valve Replacement without Tricuspid valve Repair, Fourty six (46) patients did Mitral valve Replacement with Tricuspid valve Repair and the outcome was Mortality (3.9%), Reoperaion (5.08%), Stroke (0. 56%), Re-Intubation (1.13%) and Re-Admission to ICU (1.69%) Conclusion The Reoperation has a direct relation and effect on the Mortality,Prolonged bypass time independently predicts postoperative morbidity and mortality and Prolonged aortic cross-clamp time significantly correlates with major post-operative morbidity and mortality.

scholarly journals Predicting Atrial Fibrillation After Mitral Valve Replacement

2003 ◽  
Vol 8 (1) ◽  
pp. 97-97 ◽  
Author(s):  
Bulent Gorenek ◽  
Salih Bakar ◽  
Gulmira Kudaiberdieva ◽  
Yuksel Cavusoglu ◽  
Omer Goktekin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement
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