REDUCING THE SIZE OF LEFT ATRIUM LARGE LA DURING MIRAL VALVE SURGERY WITH OR WITH OUT MAZE PROCEDURE REDUCES ATRIAL FIBRILLATION.
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Keywords
atrial fibrillation, left atrial dilatation, rheumatic heart disease
Abstract
Background: Atrial fibrillation (AF) is a common arrhythmia that significantly impacts quality of life and increases the risk of stroke and heart failure. Chronic atrial fibrillation, in particular, is often associated with left atrial (LA) dilatation. LA enlargement induced by pressure and/or volume overload, and causes various associated factors with specifically to cardiovascular diseases. There is need of new advance technique which can be relatively simple and easy to utilised during mitral valve surgery
Methods: Between May 2021 and February 2023, 40 patients (15 males, 25 females; mean age 35±10 years; range 30 to 65) underwent mitral valve surgery with left atrial reduction by posterior wall plication. Neither bipolar nor unipolar catheter ablation therapy for chronic atrial fibrillation (AF) was performed in this study. We also did not include patients in this study who had undergone radiofrequency ablation therapy for chronic AF. We include left atrial size more than 5 cm(range 5- 8 cm) and reduces 4cm to 4.5 cm
Results: At discharge, 31 patients (77.5%) were in sinus rhythm. During follow-up After 6 Months, sinus rhythm was restored in 28 patients (70%). two patient were died (5). 10 patients came for follow up with AF.Left atrium diameter was significantly reduced from 6.5±1.4 cm preoperatively to 4.6±0.5 cm at six months after surgery.
Conclusion: On the basis of our findings we can conclude that left atrial size reduction is simple, takes less time, and is also effective in maintaining sinus rhythm without adding any additional mortality or morbidity compared to mitral valve surgery alone.
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Dr. Sangram Keshari Behera
K8, Kalinga Nagar, IMS & SUM Hospital, Siksha ‘O’ Anusandhan (Deemed to be University), Bhubaneswar, 751003, India
Dr. Soumyadipta Mishra
Assistant Professor, Department of CTVS Laboratory, Institute of Medical Sciences & SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar-751003, India.
Dr. Deepak Narayan Sahoo
Associate Professor, Department of CTVS Laboratory, Institute of Medical Sciences & SUM Hospital, Siksha O Anusandhan (Deemed to be University), Bhubaneswar-751003, India.