Department Of Cardiovascular Surgery, Gulhane Training And Research Hospital, Ankara, Turkey.
Department Of Anesthesiology, Gulhane Training And Research Hospital, Ankara, Turkey.
Anatol J Cardiol. 2021 Apr;25(4):266-272. doi: 10.14744/AnatolJCardiol.2020.81669.
Atrial fibrillation (AF) is the most common arrhythmia, which is also associated with mitral valve disease. Surgical ablation is still known to be an important procedure in restoring sinus rhythm (SR) concomitant with mitral valve surgery (MVS). In this study, we aimed to pres-ent our early- and mid-term result of AF cryoablation during robotic MVS.
Between November 2014 and January 2020, total 34 patients who underwent robotic MVS with concomitant AF ablation were ret-rospectively analyzed. Ten patients had a <1 year AF history, 14 had 1-5 years, and 10 had >5 years. The primary end point of the study was postoperative AF recurrence.
Total 32 and 2 patients underwent mitral valve replacement and mitral valve repair, respectively. Mean aortic cross-clamp and cardio-pulmonary bypass times were 141.8±32.1 min and 196±25.6 min, respectively. The SR was restored with the removal of cross-clamp and cardiac junctional rhythm was observed in 29 (85.3%) and 5 (14.7%) patients, respectively. Two in-hospital deaths secondary to low cardiac output and hepatorenal failure were recorded. Among the rest, 24 (75%) patients were in SR, 6 (18.75%) in AF, and 2 (6.25%) in paced rhythm at discharge.
Robotic cryoablation of AF during MVS is a feasible method with favorable early- and mid-term results.
心房颤动（AF）是最常见的心律失常，它也与二尖瓣疾病有关。外科消融术仍然被认为是恢复窦性心律（SR）同时进行二尖瓣手术（MVS）的重要程序。在这项研究中，我们旨在介绍机器人 MVS 期间行 AF 冷冻消融的早期和中期结果。
2014 年 11 月至 2020 年 1 月，回顾性分析了 34 例行机器人 MVS 同期行 AF 消融的患者。10 例患者的 AF 病史<1 年，14 例为 1-5 年，10 例>5 年。该研究的主要终点是术后 AF 复发。
总共 32 例和 2 例患者分别行二尖瓣置换术和二尖瓣修复术。平均主动脉阻断和体外循环时间分别为 141.8±32.1min 和 196±25.6min。在 29 例（85.3%）患者中，随着主动脉阻断的去除恢复了 SR，在 5 例（14.7%）患者中观察到心脏交界性节律。记录了 2 例因低心输出量和肝肾衰竭导致的院内死亡。其余患者中，24 例（75%）为窦性心律，6 例（18.75%）为 AF，2 例（6.25%）为起搏节律出院。
机器人 MVS 期间的 AF 冷冻消融是一种可行的方法，具有良好的早期和中期结果。
