Effect of Left Atrial Reduction on Restoration and Maintenance of Sinus Rhythm in Patients Undergoing Mitral Valve Replacement: A Pilot Study.
Background This pilot study aimed to evaluate the effectiveness of posterior left atrial wall plication (T-plasty) in patients with persistent atrial fibrillation (AF) (> 7 days) undergoing mitral valve surgery. Materials and Methods A total of 60 patients who were scheduled for mitral valve replacement were randomly allocated into two groups: one would receive (Group 1; n = 32, mean age; 49.37 ± 9.00) and one would not receive (Group 2; n = 28; mean age 48.64 ± 8.6) left atrial size reduction using T-plasty technique. Patients with a clear indication for combined procedures other than tricuspid valve disease, aortic valve disease, and coronary artery stenosis were not included. Follow-up was performed at 6th, 12th, and 18th months after the operation. Results After the operation, 21 patients (65.6%) in Group 1 and 13 patients (46.4%) in Group 2 regained sinus rhythm (p = 0.13). Mortality did not occur. AF recurrence rates were not significantly different between the groups in three follow-ups. Restoration of sinus rhythm was significantly more common in Group 1 patients than in Group 2 patients during follow-up. Patients in Group 1 had lower left atrial volume indexes than those in Group 2 at the 6th and 12th months, whereas the difference at the 18th month was at the limit of significance. Conclusion We achieved satisfactory results using the T-plasty technique for left atrial size reduction in terms of mid-term restoration and preservation of normal sinus rhythm in patients undergoing mitral valve surgery. Further study may be justified to reveal the prognostic importance of the technique described herein.
Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey.
Adnan
A
Yalcinkaya
Hitit University Corum Education and Research Hospital, Department of Cardiovascular Surgery, Corum, Turkey.
Adem Ilkay
AI
Diken
Kartal Kosuyolu Education and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey.
Eray
E
Aksoy
Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey.
Gokhan
G
Lafci
Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey.
Omer Faruk
OF
Cicek
Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey.
Ersin
E
Kadirogullari
Akdeniz University, Faculty of Engineering, Department of Computer Engineering, Antalya, Turkey.
Umit Deniz
UD
Ulusar
Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey.
Kerim
K
Cagli
D000328:Adult; D001281:Atrial Fibrillation / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D016279:Atrial Function, Left; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D006339:Heart Rate; D006349:Heart Valve Diseases / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D010865:Pilot Projects; D011446:Prospective Studies; D020127:Recovery of Function; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome; D014421:Turkey