title: Atrial remodeling after mitral valve surgery in patients with permanent atrial fibrillation.
abstract: BACKGROUND
  Mitral valve pathology is frequently associated with auricular dilatation and atrial fibrillation. Mitral surgery allows an immediate surgical auricular remodeling and besides in those cases in which sinus rhythm is reached, it is followed by a late remodeling. The aim of this study is to investigate the process of postoperative auricular remodeling in patients with permanent atrial fibrillation undergoing mitral surgery.
  
  
  METHODS
  In a prospective randomized trial, 50 patients with permanent atrial fibrillation and dilated left atrium, submitted to surgical mitral repair, were divided into two groups: Group I contained 25 patients with left auricular reduction and mitral surgery, and Group II contained 25 patients with isolated valve surgery. Both groups were considered homogeneous in the preoperative assessment.
  
  
  RESULTS
  After a mean follow-up of 31 months, 46% of patients included in Group I versus 18% of patients included in Group II restarted sinus rhythm (p = 0.06). An auricular remodeling with size regression occurred in those patients who recovered from sinus rhythm, worthy of remark in Group II (-10.8% of left auricular volume reduction in Group I compared to -21.5% in Group II; p < 0.05). A new atrial enlargement took place in those patients who remained with atrial fibrillation (+16.8% left auricular volume in Group I vs. +8.4% in Group II; p < 0.05).
  
  
  CONCLUSIONS
  Mitral surgery produces an atrial postoperative volume that decrease especially when reduction techniques are employed. Late left atrial remodeling depended on the type of atrial rhythm and postoperative surgical volume.
authors.affiliation: Department of Cardiac Surgery, University General Hospital of Valencia, Spain. hornero_fer@gva.es
authors.forename: Fernando
authors.initials: F
authors.lastname: Hornero
authors.forename: Ignacio
authors.initials: I
authors.lastname: Rodriguez
authors.forename: Jose
authors.initials: J
authors.lastname: Buendía
authors.forename: Maria
authors.initials: M
authors.lastname: Bueno
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Dalmau
authors.forename: Sergio
authors.initials: S
authors.lastname: Canovas
authors.forename: Oscar
authors.initials: O
authors.lastname: Gil
authors.forename: Rafael
authors.initials: R
authors.lastname: Garcia
authors.forename: Jose A
authors.initials: JA
authors.lastname: Montero
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology*; D006348:Cardiac Surgical Procedures / Q000379:methods*; D005260:Female; D006325:Heart Atria / Q000503:physiopathology*; D006349:Heart Valve Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies