Left Atrial Longitudinal Strain Parameters Predict Postoperative Persistent Atrial Fibrillation Following Mitral Valve Surgery: A Speckle Tracking Echocardiography Study

2013 ◽  
pp. n/a-n/a ◽  
Author(s):  
Ozkan Candan ◽  
Nihal Ozdemir ◽  
Soe Moe Aung ◽  
Cem Dogan ◽  
Can Yucel Karabay ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrial ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Speckle Tracking Echocardiography ◽  
Persistent Atrial Fibrillation ◽  
Mitral Valve Surgery ◽  
Valve Surgery

scholarly journals Left Atrial Appendage Exclusion in Atrial Fibrillation Radiofrequency Ablation during Mitral Valve Surgery: A Single-Center Experience

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
C. Lavalle ◽  
M. Straito ◽  
E. Chourda ◽  
S. Poggi ◽  
G. Frati ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Maze Procedure ◽  
Circumflex Artery ◽  
Left Circumflex Artery

Background. Atrial fibrillation surgical radiofrequency ablation (AFSA) during mitral valve surgery (MVS) has almost completely superseded the Cox-Maze procedure for the treatment of atrial fibrillation. Methods. We retrospectively analyzed 100 patients who underwent MVS + AFSA in our institution from January 2008 to June 2017. We compared the effectiveness of AFSA in patients who underwent LAA exclusion to those who did not. Moreover, we analyzed the role of preoperative AF duration (≤ or >1 year) and medial-lateral left atrial dimensions (ML-LAD) (≤ or >6 cm). The efficacy endpoint was freedom from AF at discharge and at 2-year follow-up. The safety endpoints were need of a permanent pacemaker (PMK), surgical re-exploration, occurrence of stroke, and left circumflex artery or esophageal lesions. Results. Overall, the rate of AF freedom was 69% at discharge and 80% at 2-year follow-up. LAA exclusion did not influence AF freedom at 2-year follow-up, and 84.6% of patients who underwent LAA exclusion were in the sinus rythm (SR) at 2 year compared to 75% of those who did not receive LAA exclusion free from AF as well ( p = 0.230 ). AF duration ≤1 or >1 year did not influence sinus rhythm (SR) maintenance (85.7% vs. 75.8%; p = 0.224 ), and in these two groups, LAA exclusion did not change the efficacy of AFSA. ML-LAD ≤ 6 cm was associated with better results in terms of SR maintenance. A statistically significant association between LAA exclusion and SR maintenance at 2-year follow-up ( p = 0.017 ) was found among patients with ML-LAD ≤ 6 cm. Complications included 7 cases of PMK implantation, 2 cases of surgical re-exploration, and 1 case of stroke. No circumflex artery or esophageal lesions occurred after surgical procedures. Conclusions. In our experience, AFSA during isolated MVS resulted in good outcomes in terms of SR maintenance and incidence of complications. AF duration ≤ 1 year did not influence results, while patients with ML-LAD ≤ 6 cm had significantly better results regarding SR at follow-up. In patients with ML-LAD ≤ 6 cm, LAA exclusion significantly increased the success rate of SR maintenance at 2-year follow-up.

scholarly journals Predictors of Failure Cardioversion for Recurrent Atrial Fibrillation Following Mitral Valve Surgery With Ablation

2020 ◽  
Vol 23 (3) ◽  
pp. E300-E304
Author(s):  
Hailong Cao ◽  
Xin Chen ◽  
Xiyu Zhu ◽  
Yining Yang ◽  
Qing Zhou ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Atrial Flutter ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Loading Dose ◽  
Left Atrial Diameter ◽  
Recurrent Atrial Fibrillation

Background: Electrical cardioversion (ECV) often is required for terminating recurrent atrial fibrillation (AF) after surgical radiofrequency ablation in patients undergoing mitral valve surgery. However, ECV is unsuccessful in some cases. In this study, we aimed to identify possible predictors of failed ECV for recurrent atrial fibrillation following mitral valve surgery with concomitant radiofrequency ablation. Methods: We enrolled 1,136 persistent AF patients with history of mitral valve surgery and concomitant radiofrequency ablation. Three-hundred-nineteen patients experienced recurrence of persistent AF and received ECV therapy. Comparison was made between patients with failed ECV (Failure group, N = 68) and successful ECV (Success group, N = 251). Results: In multivariate regression analysis, age, pre-ECV loading-dose amiodarone, left atrial diameter, atrial flutter and time from surgery to ECV were independent predictors for outcomes of ECV. According to receiver operating characteristic curve analysis, the best threshold values of age, left atrial diameter and time from surgery to ECV for predicting failed ECV were 55.5 years, 64.5 mm, and 90.5 days, respectively. Conclusion: Older age, larger left atrium and longer time from surgery to ECV are independent predictors for failed ECV in this group. Compared with AF, atrial flutter is easier to be successfully terminated by ECV. Pre-ECV loading-dose amiodarone is helpful for successful ECV. These findings have important implications for identifying the kinds of patients to receive effective ECV.

scholarly journals Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

JAMA ◽  
2005 ◽  
Vol 294 (18) ◽  
pp. 2323 ◽  
Author(s):  
George Doukas ◽  
Nilesh J. Samani ◽  
Christos Alexiou ◽  
Mehmet Oc ◽  
Derek T. Chin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Mitral Valve ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery

scholarly journals Myocardial adaptation as assessed by speckle tracking echocardiography after isolated mitral valve surgery for primary mitral regurgitation

2020 ◽  
Author(s):  
Muhammed Gerçek ◽  
Lothar Faber ◽  
Volker Rudolph ◽  
Henrik Fox ◽  
Thomas Puehler ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Tricuspid Regurgitation ◽  
Exercise Tolerance ◽  
Speckle Tracking ◽  
Longitudinal Strain ◽  
Contractile Function ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Primary Mitral Regurgitation

Abstract The risk of left ventricular (LV) and right ventricular (RV) maladaptation after surgery for isolated primary mitral regurgitation (PMR) is poorly defined. We aimed to evaluate LV and RV contractile function using speckle-tracking analysis alongside with quantification of exercise tolerance in patients with PMR after mitral valve surgery. All consecutive patients with symptomatic PMR undergoing mitral valve surgery between July 2015 and May 2017 were prospectively enrolled. Sequential echocardiographic studies along with clinical assessment were performed before and three months after surgery. Mean age in 138 patients was 65.8 ± 12.7 years, 48.2% (66) of whom were female. Mean LV ejection fraction decreased from 57 ± 12% to 50 ± 11% (p < 0.001), LV global longitudinal strain deteriorated from −19.2 ± 4.1% to −15.7 ± 3.8% (p < 0.001), and mechanical strain dispersion increased from 88 ± 12 to 117 ± 115 ms (p = 0.004). There was a reduction in tricuspid annulus plane systolic excursion from 22 ± 5 mm to 18 ± 4 mm (p < 0.001), as well as a slight deterioration of RV free wall mean longitudinal strain from −16.9 ± 5.6% to −15.7 ± 4.1% (p = 0.05). The rate of moderate to severe tricuspid regurgitation significantly decreased (p < 0.005). Regarding exercise tolerance, the New York Heart Association class improved (p < 0.001) and the walking distance increased (p < 0.001). During mid-term follow up after surgery for PMR, a deterioration of LV and RV contractile function measures could be observed. However, the clinical status, LV dimensions, and concomitant tricuspid regurgitation improved which in particular imply more effective RV contractile pattern.

Atrial function after left atrial epicardial cryoablation for atrial fibrillation in patients undergoing mitral valve surgery

2011 ◽  
Vol 33 (1) ◽  
pp. 85-91 ◽  
Author(s):  
Birgitta Johansson ◽  
Odd Bech-Hanssen ◽  
Eva Berglin ◽  
Per Blomström ◽  
Anders Holmgren ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Left Atrial ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Atrial Function
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