Li Dong1, Bo Fu1, Xiao Teng1, Hong-Sheng Yuan1, Shu-Lin Zhao1, Li Ren2. 1. Department of Cardiac Surgery, West China Hospital, Sichuan University, Chengdu, China. 2. Department of Oncology, West China Hospital, Sichuan University, Chengdu, China. Electronic address: renlihx@163.com.
Abstract
OBJECTIVE: The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. METHODS: A total of 191 patients with rheumatic heart disease and chronic atrial fibrillation underwent valve replacement with concomitant bipolar radiofrequency ablation. There were 78 male and 113 female patients with a mean age of 46.0 ± 9.1 years and an atrial fibrillation duration of 43.7 ± 15.4 months. Valve replacement surgery included mitral valve replacement in 121 patients, mitral and aortic valve replacement in 59 patients, mitral and tricuspid valve replacement in 8 patients, and triple valve replacement in 3 patients. All patients received oral antiarrhythmic drugs for 3 to 6 months postoperatively. Follow-up electrocardiography and color Doppler echocardiography were performed postoperatively. RESULTS: The mean aortic crossclamping time was 84.0 ± 25.5 minutes, and cardiopulmonary bypass time was 139.4 ± 39.1 minutes. There was no abnormal bleeding due to bipolar radiofrequency ablation. Three patients (1.57%) died of low cardiac output syndrome in hospital at 2, 3, and 5 days after surgery. Major perioperative complications include reoperation for bleeding (n = 1), reoperation for wound infection (n = 1), intra-aortic balloon pump placement (n = 2), and renal failure (n = 2). All other patients were discharged without complications. The mean follow-up time was 17.4 ± 11.8 months with a follow-up rate of 95.3%. There were no cases of late death, complete atrioventricular block, or anticoagulation-induced complications. Of 158 patients who were followed up for 1 year, sinus rhythm was maintained in 125 (79.11%). CONCLUSIONS: Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results. Crown
OBJECTIVE: The study objective was to evaluate the safety and efficacy of concomitant bipolar radiofrequency ablation and heart valve replacement in patients with rheumatic heart disease and atrial fibrillation. METHODS: A total of 191 patients with rheumatic heart disease and chronic atrial fibrillation underwent valve replacement with concomitant bipolar radiofrequency ablation. There were 78 male and 113 female patients with a mean age of 46.0 ± 9.1 years and an atrial fibrillation duration of 43.7 ± 15.4 months. Valve replacement surgery included mitral valve replacement in 121 patients, mitral and aortic valve replacement in 59 patients, mitral and tricuspid valve replacement in 8 patients, and triple valve replacement in 3 patients. All patients received oral antiarrhythmic drugs for 3 to 6 months postoperatively. Follow-up electrocardiography and color Doppler echocardiography were performed postoperatively. RESULTS: The mean aortic crossclamping time was 84.0 ± 25.5 minutes, and cardiopulmonary bypass time was 139.4 ± 39.1 minutes. There was no abnormal bleeding due to bipolar radiofrequency ablation. Three patients (1.57%) died of low cardiac output syndrome in hospital at 2, 3, and 5 days after surgery. Major perioperative complications include reoperation for bleeding (n = 1), reoperation for wound infection (n = 1), intra-aortic balloon pump placement (n = 2), and renal failure (n = 2). All other patients were discharged without complications. The mean follow-up time was 17.4 ± 11.8 months with a follow-up rate of 95.3%. There were no cases of late death, complete atrioventricular block, or anticoagulation-induced complications. Of 158 patients who were followed up for 1 year, sinus rhythm was maintained in 125 (79.11%). CONCLUSIONS: Concomitant bipolar radiofrequency ablation is an effective and safe technique for treating atrial fibrillation in patients with rheumatic heart disease undergoing valve replacement, with promising follow-up results. Crown