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 A Giant Left Atrium due to Rheumatic Mitral Regurgitation, Outcome after Left Atrial Reduction Surgey with Mitral Valve Replacement

2018 ◽  
Vol 14 (1) ◽  
pp. 42-44
Author(s):  
Istiaq Ahmed ◽  
Sorower Hossain ◽  
Ankan Kumar Paul
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Left Atrium ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Left Atrial ◽  
Quick Recovery ◽  
Replacement Surgery ◽  
Atrial Size ◽  
Giant Left Atrium

A trans-thoracic echocardiography and chest radiograph of a 26 year old lady diagnosed as rheumatic mitral regurgitation with atrial fibrillation revealed a giant left atrium of 10.9 cm size with symptoms of dyspnoea and palpitation. The patient was treated with left atrial size reduction along with mitral valve replacement surgery and showed an excellent and quick recovery with total disappearance of symptoms and restoration of sinus rhythm only within few days.University Heart Journal Vol. 14, No. 1, Jan 2018; 42-44

scholarly journals Study of Correlation of Left Atrial Size and Atrial Fibrillation in Rheumatic Mitral Valve Disease

2019 ◽  
Vol 17 (2) ◽  
pp. 7-9
Author(s):  
Anil Shrestha ◽  
Richa Shrestha
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Sinus Rhythm ◽  
Mitral Valve Disease ◽  
Left Atrial ◽  
Valve Disease ◽  
Left Atrial Size ◽  
Predisposing Factor ◽  
Cross Sectional ◽  
Atrial Size

Aim: To study the correlation between Atrial Fibrillation (AF) and left atrial size in Rheumatic Mitral valve disease (RMVD). Background: AF is the most common sustained cardiac arrhythmia which is associated with increased cardiovascular morbidity, mortality and preventable stroke. AF is common in rheumatic heart disease (RHD) particularly mitral stenosis (MS). LA dilatation is the predisposing factor for the development of AF in RMVD. Methodology: This is a hospital based cross sectional descriptive study conducted in 52 patients who were diagnosed as RMVD clinically and echocardiographically in NGMCTH, Kohalpur between December 2018 to November 2019. Detailed history and complete clinical examination were performed. Standard 12 lead ECG and 2-D echocardiography were done. Left atrial size was measured and compared with patients in AF and with sinus rhythm. Result: The age of patients ranged from 20-76 years with the mean age of 40.33 years. Out of 52 patients 30 were in AF and 23 in sinus rhythm. Among 30 patients in AF, 27 (90%) had LA size ≥ 4 cm with mean LA size of 4.6 cm whereas among 22 patients in sinus rhythm, 14 (63.64%) had LA Size <4 cm with a mean of 3.83 cm. Conclusion: Left atrial size ≥ 4 cm is the predisposing factor for the development of AF in rheumatic mitral valve disease. Therefore, if patients in sinus rhythm who are at high risk of developing AF are identified, prophylactic anticoagulation and antiarrythmic drug might prevent AF induced embolism and exacerbation of symptoms in rheumatic mitral valve disease.  

scholarly journals Correlation of atrial fibrillation and left atrial size in rheumatic mitral valve disease

2020 ◽  
Vol 8 (1) ◽  
pp. 7
Author(s):  
Malli Dorasanamma ◽  
U. Gangaram ◽  
B. Indeevar Prasad
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Sinus Rhythm ◽  
Mitral Valve Disease ◽  
Left Atrial ◽  
Andhra Pradesh ◽  
Valve Disease ◽  
Left Atrial Size ◽  
Predisposing Factor ◽  
Atrial Size

Background: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia which is as associated with increased cardiovascular morbidity, mortality and preventable stroke. AF is common in rheumatic heart disease (RHD) particularly mitral stenosis (MS). Left atrial (LA) dilatation is the predisposing factor for the development of AF in rheumatic mitral valve disease. Aim was to study the correlation between AF and LA size in rheumatic mitral valve disease in the population of Southern Andhra Pradesh.  Methods: This is a prospective, observational study conducted in 42 patients diagnosed to have RMVD in Narayana Medical College and Hospital, Nellore, Andhra Pradesh between August 2018 and July 2020. Detailed patient history and complete clinical examination were performed. Standard 12 lead Electrocardiography (ECG) and 2-D echocardiography were done. Left atrial size was measured and compared with patients in AF and with sinus rhythm.  Results: The age of patients ranged from 20-76 years with the mean age of 40.33 years. Out of 42 patients 26 were in AF and 16 in sinus rhythm. Among 26 patients in AF, 22 (84.6%) had LA size ≥4 cm and 4 (15.38%) had <4 cm with mean LA size of 4.6 cm whereas among 16 patients in sinus rhythm, 10 (62.5%) had LA size <4 cm and 6 (37.5%) had ≥4 cm with a mean of 3.83 cm.  Conclusions: Left atrial size ≥4 cm is the predisposing factor for the development of AF in rheumatic mitral valve disease. Therefore, if patients in sinus rhythm who are at high risk of developing AF are identified, prophylactic anticoagulation and antiarrythmic drugs might prevent AF induced complications like embolism and symptom exacerbation in rheumatic mitral valve disease.

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.

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