Clinical analysis of concomitant valve replacement and bipolar radiofrequency ablation in 191 patients
| Autor: | Li Ren, Bo Fu, Hong-sheng Yuan, Shu-lin Zhao, Li Dong, Xiao Teng |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Pulmonary and Respiratory Medicine medicine.medical_specialty Heart disease medicine.medical_treatment Heart Valve Diseases Catheter ablation Young Adult Aortic valve replacement Valve replacement Internal medicine Atrial Fibrillation medicine Humans Sinus rhythm Aged Heart Valve Prosthesis Implantation medicine.diagnostic_test business.industry Rheumatic Heart Disease Mitral valve replacement Atrial fibrillation Middle Aged medicine.disease Surgery Chronic Disease Catheter Ablation cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Electrocardiography |
| Zdroj: | The Journal of Thoracic and Cardiovascular Surgery. 145:1013-1017 |
| ISSN: | 0022-5223 |
| DOI: | 10.1016/j.jtcvs.2012.05.009 |
| Popis: | Objective The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. Methods A total of 191 patients with rheumatic heart disease and chronic atrial fibrillation underwent valve replacement with concomitant bipolar radiofrequency ablation. There were 78 male and 113 female patients with a mean age of 46.0 ± 9.1 years and an atrial fibrillation duration of 43.7 ± 15.4 months. Valve replacement surgery included mitral valve replacement in 121 patients, mitral and aortic valve replacement in 59 patients, mitral and tricuspid valve replacement in 8 patients, and triple valve replacement in 3 patients. All patients received oral antiarrhythmic drugs for 3 to 6 months postoperatively. Follow-up electrocardiography and color Doppler echocardiography were performed postoperatively. Results The mean aortic crossclamping time was 84.0 ± 25.5 minutes, and cardiopulmonary bypass time was 139.4 ± 39.1 minutes. There was no abnormal bleeding due to bipolar radiofrequency ablation. Three patients (1.57%) died of low cardiac output syndrome in hospital at 2, 3, and 5 days after surgery. Major perioperative complications include reoperation for bleeding (n = 1), reoperation for wound infection (n = 1), intra-aortic balloon pump placement (n = 2), and renal failure (n = 2). All other patients were discharged without complications. The mean follow-up time was 17.4 ± 11.8 months with a follow-up rate of 95.3%. There were no cases of late death, complete atrioventricular block, or anticoagulation-induced complications. Of 158 patients who were followed up for 1 year, sinus rhythm was maintained in 125 (79.11%). Conclusions Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results. |
| Databáze: | OpenAIRE |
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