[One-Stage Application of Mitral Valve Correction, Surgical Radiofrequency Ablation and Left Atrial Atrioplasty].
OBJECTIVE
Our aim was to evaluate sinus rhythm restoration and its failure predictors after one-stage application of surgical radiofrequency ablation, left atrial reduction and mitral valve correction.


METHODS
This is a prospective longitudinal cohort study with historical controls. Patients were divided into 2 groups according to the performed type of operation--the main group included patients undergone one-stage mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty (n = 47); and the control group consisted of patients undergone only mitral valve correction (n = 76). Surgical radiofrequency ablation was performed under the scheme Maze-IV. Left atrial atrioplasty procedure was performed according to echocardiography data: if in women LA antero-posterior dimensions were more than 4.7 cm and in men more than 5.2 cm.


RESULTS
The study included 123 patients. In the main group (age of the patients 61.0 ± 9.1 years, 55% male) sinus rhythm restoration was observed in 32 (68%) patients during the early postoperative period, but at the time of discharge it reduced to 19 (40%), but in 6 months it increased up to 37 (78%), and in 36 months sinus rhythm already was detected in 40 (85%) patients. At the same time, during the early postoperative period in the control group (patients aged 59.0 ± 11.0 years, 61% male) only 31 (40%) of patients had sinus rhythm, in 6 months it was detected in 11 (14%) cases, and in 36 months sinus rhythm--only in 28 (37%) patients. Predictors of atrial fibrillation recurrence were revealed: valve disease continuance < 4 years (p = 0.017) and atrial fibrillation history < 3 years (p =0.029).


CONCLUSIONS
One-stage peforming of mitral valve correction, surgical radiofrequency ablation and left atrial atrioplasty restores and maintains more regular sinus rhythm, even in presence of atrial fibrillation recurrence predictors.
S D
SD
Joshibayev
B A
BA
Bolatbekov
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D018421:Cardiomyoplasty / Q000009:adverse effects / Q000379:methods; D017115:Catheter Ablation / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D004452:Echocardiography / Q000379:methods; D005260:Female; D006325:Heart Atria / Q000601:surgery; D006339:Heart Rate; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D006801:Humans; D007623:Kazakhstan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000473:pathology / Q000601:surgery; D058386:Mitral Valve Annuloplasty / Q000009:adverse effects / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000517:prevention & control; D011184:Postoperative Period; D011446:Prospective Studies; D015203:Reproducibility of Results