Long-term Results of Surgical Treatment of Atrial Fibrillation Combined with Mitral Valve Pathology

Lasha D. Shengelia, Leo A. Bockeria, Olga L. Bockeria, Zamik F. Fatulaev, Marina Yu. Mironenko, Vladimir A. Shvartz , Igor Ya. Klimchuk

A.N. Bakulev Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–A

Abstract

Purpose: to analyze long-term results of surgical treatment of atrial fibrillation (AF) combined with mitral valve (MV) pathology

Methods: study included 197 patients. Mean age was 55±8 years, 62% were men.

Patients were divided into three groups: maze procedure combined with MV replacement (69 patients), MV repair due to mitral regurgitation (MR) secondary to AF (67 patients), MV repair due to primary MR (61 patients).

First group: LVEF– 52±4%, peakMV gradient - 17 mm Hg, MR– 2(1,5;2).

Second group:LVEF - 59±8%,MR–2 (2;2,5),MV annulus-37±3 mm, TV regurgitation (TR) –2 (2;2,5),TV annulus–37±3 mm,MR fraction–54±10%, vena contracta (VC)–0,7 (0,6; 0,8)cm,ERO–0,22±0,07 см².

Third group:- 68±9%,MR–3 (2,5;3,5), TR–2,5 (2,5;3),MV annulus –37±3 mm,TV annulus–40 (39;43) mm, MR fraction–71±5, VC–0,9 (0,7; 0,9),cm,ERO–0,26±0,09см².

Results:Median follow-up was32 (23;37)months. Freedom from AF in the first group was 82%, in the second– 92%, in the third– 89%.

First groupLVEF–52±4%, peak MV gradient was 9 mm Hg(p<0,05), MR–1(0,5;1) (p<0,05).

Second group:LVEF - 58± 5% (p>0,05), MR–1(1;1,5), (p<0,001),MV annulus–33±2,3mm, (p<0,001), TR– 1(1;1,5) (p<0,001),TV annulus–33(31;34) mm (p<0,001),MR fraction–12 (8;17)% (p<0,01), VC–0,33 (0,28;0,47) (p<0,05)cm,ERO–0,13 (0,08;0,23)см²(p<0,05).

Third group:LVEF - 58±9%(p>0,05), MR–1,5 (1;2) (p<0,05), TR–1,5 (1;1,5) (p<0,05),MV annulus–34±3 mm (p<0,05),TV annulus–34 (32;36) mm (p<0,05), MR fraction–19±5% (p<0,05), VC–0,2 (0,1; 0,3)cm(p<0,05), ERO - 0,05± 0,02см²(p<0,05) cm².

Conclusions:surgical treatment of AF combined with MV pathology is effective, allows to achieve high rate of freedom from AF and also provides significant improvement in valve function in long-term follow up in different groups.