Left Atrial Reduction Plasty and Sinus Rhythm Restoration in patients undergoing Mitral Valve Surgery with Chronic Atrial Fibrillation

Autor: Nasir Ali, Atif Nawaz, Imtiaz Ahmed Chaudhry, Muhammad Imran Asghar, Syed Aqeel Hussain, Rehan Masroor, Muhammad Ahmad Khan
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Pakistan Armed Forces Medical Journal, Vol 73, Iss SUPPL-3 (2023)
Druh dokumentu: article
ISSN: 0030-9648
2411-8842
DOI: 10.51253/pafmj.v73iSUPPL-3.10935
Popis: Objective: To assess outcome of Left Atrial reduction plasty and sinus rhythm restoration in patients undergoing Mitral valve surgery with chronic Atrial Fibrillation. Study Design: Longitudinal study. Place and Duration of Study: Adult Cardiac Surgery Unit, Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Jan 2017-Jun 2022. Methodology: Thirty three (n=33) patients with mitral valve disease were recruited via convenience sampling, all of whom exhibited an enlarged left atrium and pre-operative Atrial Fibrillation (AF). Pre-operative cardiac evaluations were performed using Transthoracic Echocardiography (TTE). Pre- and post-surgery trans-esophageal echocardiography studies were conducted as a routine procedure. Follow-up echocardiographic assessments were carried out at intervals of 1 month, 3 months, and 6 months, alongside Electrocardiograms (ECGs). During surgery, median sternotomy was done. Cardiopulmonary Bypass (CPB) time was established followed by cardiac arrest. After Mitral valve Repair/Replacement (MVR), Left Atrial (LA) plication was done by a double needle. Results: Out of thirty three (n=33) patients, 25(75.7%) females and 8(24.2%) male patients, with mean age of 44.3±15.5 years, underwent mitral valve surgery(repair/replacement) followed by LA reduction & sinus rhythm restoration procedure. Complete restoration of sinus rhythm with re-appearance of “a” wave on echocardiography, signifying LA transport function through mitral valve was observed in 31(93.9%) patients on 3rd month and only 1(3.0%) individual continued to have persistent AF after 6 months. (83.70±2.50 mm vs. 47.50±1.08 mm) (p
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