Influence of Preoperative Atrial Fibrillation on Late Results of Mitral Repair: Is Concomitant Ablation Justified?

Ngaage, Dumbor L.; Schaff, Hartzell V.; Mullany, Charles J.; Barnes, Sunni A.; Dearani, Joseph A.; Daly, Richard C.; Orszulak, Thomas A.; Sundt, Thoralf M.

doi:10.1016/j.athoracsur.2007.04.036

Cited by 102 publications

(64 citation statements)

References 25 publications

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“…W przybliżeniu u 30% pacjentów z AF występuje jakiegoś rodzaju wada zastawkowa, często wykrywana tylko za pomocą echokardiografii [201,[253][254][255]. Migotanie przedsionków pogarsza rokowanie u pacjentów z ciężkimi wadami zastawkowymi [256], w tym u poddawanych operacji lub interwencjom przezcewnikowym z powodu wady zastawki aortalnej lub mitralnej [257][258][259][260][261][262]. Wady zastawkowe mogą się wiązać ze zwiększonym ryzykiem zakrzepowo-zatorowym, które prawdopodobnie sumuje się z ryzykiem udaru mózgu u pacjentów z AF [263].…”

Section: Wady Zastawkoweunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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Section: Wady Zastawkoweunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,380

4,206

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“…AF did not have an independent effect on survival after MV repair; this finding is corroborated by other studies. 28,29 We found the duration of follow-up and the degree of myxomatous degeneration was associated with risk of postoperative late AF in patients who did not have AF before surgery. The maze procedure was effective in reducing the risk of late AF in patients with preoperative AF.…”

mentioning

confidence: 95%

“…Thus, it appears reasonable to combine the maze procedure to MV repair in patients with preoperative AF. 29 Infective endocarditis was rare in our series of MV repairs, and only 9 patients developed this complication. Unlike heart valve replacement, which is associated with a relatively higher risk of infective endocarditis early on after surgery, 30 there was not a single event during the first year of follow-up in our series of MV repair.…”

mentioning

confidence: 99%

Late Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease

et al. 2013

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Background-The pathological spectrum of degenerative diseases of the mitral valve (MV) that causes mitral regurgitation (MR) is broad, and there is limited information on late outcomes of MV repair in various subgroups of patients and pathologies. This study examines this issue. Methods and Results-All 840 patients who had MV repair for MR due to degenerative diseases from 1985 to 2004 were prospectively followed with clinical and echocardiographic evaluations at biennial intervals up to 26 years, median of 10.4 years. Clinical, hemodynamic, and pathological variables were evaluated for their association with outcomes. Age, left ventricular ejection fraction, and functional class were predictors of late cardiac-and valve-related deaths by multivariable analysis. MV repair failed to restore life span to normal in patients with functional class IV. Thirty-eight patients had repeat MV surgery, and the probability of reoperation at 20 years was 5.9%. During the follow-up, recurrent severe MR developed in 37 patients, and moderate MR developed in 61. Age, isolated prolapse of the anterior leaflet, the degree of myxomatous changes in the MV, lack of mitral annuloplasty, and duration of cardiopulmonary bypass were associated with increased risk of recurrent MR. At 20 years, the freedom from recurrent severe MR was 90.7%, and the freedom from moderate or severe MR was 69.2%. Conclusions-MV

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“…The presence of AF before surgery is associated with long-term mortality and post-operative LV dysfunction. 21,22 As such, patients with new onset of AF are particularly well-suited for surgery as there is a chance that sinus rhythm may be restored following surgery, before AF begets more AF and the LA dilates permanently. The presence of AF represents a class IIa indication for mitral valve surgery.…”

Section: Atrial Fibrillationmentioning

confidence: 99%

Management of Asymptomatic Severe Degenerative Mitral Regurgitation

Lancellotti

Marchetta

et al. 2017

Structural Heart

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The decision for surgery in the management of asymptomatic severe degenerative mitral regurgitation (MR) is about doing the right thing at the right time and place. European and American guidelines have provided us with guidance on surgical indications, albeit with different levels of recommendations. However, the timing for surgery especially in asymptomatic patients not meeting Class I indications for intervention, i.e. no evidence of left ventricular dysfunction is still avidly debated. In this review, we will present the literature on the indications and timing of surgical intervention in asymptomatic severe MR, covering guidelines from both societies. We will also touch on the emerging role of other imaging techniques, biomarkers and exercise stress testing. Finally, we will present arguments for and against both management strategies, i.e. early surgery and watchful waiting. To summarize, the management of patients with asymptomatic severe degenerative MR should be a joint decision between all members of the Heart Team and tailored according to the availability of surgical expertise, patient's surgical risk and patient's wishes.

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Influence of Preoperative Atrial Fibrillation on Late Results of Mitral Repair: Is Concomitant Ablation Justified?

Cited by 102 publications

References 25 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Late Outcomes of Mitral Valve Repair for Mitral Regurgitation Due to Degenerative Disease

Management of Asymptomatic Severe Degenerative Mitral Regurgitation

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