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find Author "FU Peng" 1 results
  • Clinical Analysis of Concomitant Mitral Valve Replacement and Bipolar Radiofrequency Ablation for Chronic AtrialFibrillation

    Objective To evaluate clinical results of concomitant mitral valve replacement (MVR) and modified maze procedure with Atricure bipolar radiofrequency for chronic atrial fibrillation (AF). Methods Clinical data of 59 patients with mitral valve diseases and chronic AF who underwent concomitant MVR and bipolar radiofrequency ablation in Subei People’s Hospital from June 2010 to September 2012 were retrospectively analyzed. There were 22 male and 37 female patients with their age of 29-71 (48±11) years. The AF duration was 1.2-26.0 (7.2±3.4) years. Preoperatively,there were 20 patients with New York Heart Association (NYHA) class Ⅱ,31 patients with NYHA class Ⅲ and 8 patients with NYHA class Ⅳ. There were 32 patients with moderate to severe mitral stenosis,9 patients with moderate to severe mitral regurgitation and 18 patients with combined mitral stenosis and regurgitation. There were 42 patients with tricuspid regurgitation. The left artial dimension was 39-98 (55.2±8.9) mm. Left atrial thrombus was found in 9 patients. Atricure bipolar radiofrequency system was used for right atrial ablation under normothermic cardiopulmonary bypass (CPB) with beating heart first,then for ablations of the left and right pulmonary vein orifices and left atrium under moderate hypothermia with heart arrest. MVR was performed after ablation procedures were completed. Amiodarone was routinely used postoperatively and patients were periodically followed up after discharge. Results There was no in-hospital death. CPB time was 65-180 (99±28)minutes,aortic cross-clamping time was 46-123 (69±17)minutes,and ablation time was 15-28 (21±4)minutes. Postoperatively,heart rhythm immediately changed to sinus rhythm (SR) in 44 patients,remained AF in 10 patients and atrial flutter in 1 patient. Temporary pacemaker was used for 4 patients with bradycardia (3 patients recovered SR and 1 patient remained AF later). Fifty-eight patients were followed up after discharge for 6-33 months,and 1 patient was lost during follow-up. Patients’ SR rate was 86.2 % (50/58),91.4% (53/58),89.7 % (52/58),84.6 % (33/39)and 71.4 % (5/7)at discharge,3 months,6 months,1 year and 2 years after discharge respectively. There was no thrombotic event during follow-up. Conclusion Concomitant MVR and modified maze procedure with Atricure bipolar radiofrequency is a safe procedure for chronic AF with good short-term results.

    Release date:2016-08-30 05:47 Export PDF Favorites Scan
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