Chavez Ernesto Koehler, Colafranceschi Alexandre Siciliano, Monteiro Andrey José de Oliveira, Canale Leonardo Secchin, Mesquita Evandro Tinoco, Weksler Clara, Barbosa Odilon Nogueira, Oliveira Anderson
Instituto Nacional de Cardiologia (INC), Rio de Janeiro, RJ, Brazil.
Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.
Braz J Cardiovasc Surg. 2017 May-Jun;32(3):202-209. doi: 10.21470/1678-9741-2017-0016.
: To assess heart rhythm and predictive factors associated with sinus rhythm after one year in patients with rheumatic valve disease undergoing concomitant surgical treatment of atrial fibrillation. Operative mortality, survival and occurrence of stroke after one year were also evaluated.
: Retrospective longitudinal observational study of 103 patients undergoing rheumatic mitral valve surgery and ablation of atrial fibrillation using uni- or bipolar radiofrequency between January 2013 and December 2014. Age, gender, functional class (NYHA), type of atrial fibrillation, EuroSCORE, duration of atrial fibrillation, stroke, left atrial size, left ventricular ejection fraction, cardiopulmonary bypass time, myocardial ischemia time and type of radiofrequency were investigated.
: After one year, 66.3% of patients were in sinus rhythm. Sinus rhythm at hospital discharge, lower left atrial size in the preoperative period and bipolar radiofrequency were associated with a greater chance of sinus rhythm after one year. Operative mortality was 7.7%. Survival rate after one year was 92.3% and occurrence of stroke was 1%.
: Atrial fibrillation ablation surgery with surgical approach of rheumatic mitral valve resulted in 63.1% patients in sinus rhythm after one year. Discharge from hospital in sinus rhythm was a predictor of maintenance of this rhythm. Increased left atrium and use of unipolar radiofrequency were associated with lower chance of sinus rhythm. Operative mortality rate of 7.7% and survival and stroke-free survival contribute to excellent care results for this approach.
评估风湿性瓣膜病患者在接受房颤同步外科治疗后一年的心律及与窦性心律相关的预测因素。同时评估手术死亡率、一年后的生存率及卒中发生率。
对2013年1月至2014年12月期间103例行风湿性二尖瓣手术并使用单极或双极射频消融房颤的患者进行回顾性纵向观察研究。调查患者的年龄、性别、心功能分级（纽约心脏协会）、房颤类型、欧洲心脏手术风险评估系统评分、房颤持续时间、卒中史、左心房大小、左心室射血分数、体外循环时间、心肌缺血时间及射频类型。
一年后，66.3%的患者为窦性心律。出院时为窦性心律、术前左心房较小及使用双极射频与一年后窦性心律的可能性更大相关。手术死亡率为7.7%。一年后的生存率为92.3%，卒中发生率为1%。
采用风湿性二尖瓣手术方法进行房颤消融手术，一年后63.1%的患者为窦性心律。出院时为窦性心律是这种心律维持的一个预测因素。左心房增大及使用单极射频与窦性心律的可能性较低相关。7.7%的手术死亡率以及生存率和无卒中生存率表明这种治疗方法效果良好。
