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Ablation for atrial fibrillation during mitral valve surgery: 1-year results through continuous subcutaneous monitoring.

https://arctichealth.org/en/permalink/ahliterature125117
Source
Interact Cardiovasc Thorac Surg. 2012 Jul;15(1):37-41
Publication Type
Article
Date
Jul-2012
Author
Alexandr Bogachev-Prokophiev
Sergey Zheleznev
Alexander Romanov
Evgeny Pokushalov
Alexey Pivkin
Giorgio Corbucci
Alexander Karaskov
Author Affiliation
Department of Heart Valves Surgery, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation. b-pav@rambler.ru
Source
Interact Cardiovasc Thorac Surg. 2012 Jul;15(1):37-41
Date
Jul-2012
Language
English
Publication Type
Article
Keywords
Atrial Fibrillation - complications - diagnosis - mortality - surgery
Atrial Flutter - diagnosis - etiology - mortality
Catheter Ablation - adverse effects - mortality
Chi-Square Distribution
Disease-Free Survival
Electrocardiography, Ambulatory
Female
Heart Valve Diseases - complications - mortality - surgery
Heart Valve Prosthesis Implantation - adverse effects - mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mitral Valve - surgery
Predictive value of tests
Prospective Studies
Recurrence
Risk assessment
Risk factors
Russia
Time Factors
Treatment Outcome
Abstract
Continuous monitoring of cardiac rhythm may play an important role in measuring the true symptomatic/asymptomatic atrial fibrillation (AF) burden and improve the management of anti-arrhythmic and anti-thrombotic therapies. Forty-seven patients with mitral valve disease and longstanding persistent AF (LSPAF) underwent a left atrial maze procedure with bipolar radiofrequency and valve surgery. The follow-up data recorded by an implanted loop recorder were analysed after 3, 6 and 12 months. On discharge, 40 (85.1%) patients were in stable sinus rhythm, as documented by in-office electrocardiography (ECG), 4 (8.5%) were in pacemaker rhythm and 3 (6.4%) were in AF. One (2.1%) patient died after 7 months. On 12-month follow-up examination, 30 (65.2%) patients had an AF burden 0.5%. Two (4.3%) patients with AF recurrences were completely asymptomatic. Among the symptomatic events stored by the patients, only 27.6% was confirmed as genuine AF recurrences according to the concomitant ECG recorded by the implanted loop recorder. A concomitant bipolar maze procedure during mitral valve surgery is effective in treating AF, as proved by detailed 1-year continuous monitoring.
Notes
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PubMed ID
22514258 View in PubMed
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An evaluation of mitral valve procedures using the European system for cardiac operative risk evaluation.

https://arctichealth.org/en/permalink/ahliterature155041
Source
Scand J Surg. 2008;97(3):254-8
Publication Type
Article
Date
2008
Author
T. Kaartama
L. Heikkinen
A. Vento
Author Affiliation
Department of Cardiothoracic Surgery, Helsinki University Central Hospital, Helsinki, Finland.
Source
Scand J Surg. 2008;97(3):254-8
Date
2008
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cardiac Surgical Procedures - methods
Female
Finland - epidemiology
Follow-Up Studies
Heart Valve Diseases - mortality - surgery
Humans
Length of Stay - trends
Male
Middle Aged
Mitral Valve - surgery
Retrospective Studies
Risk Assessment - methods
Risk factors
Survival Rate - trends
Treatment Outcome
Abstract
This study was undertaken in order to evaluate the usefulness of the Euroscore in the choice and outcome of mitral valve procedures undertaken at the Helsinki University Central Hospital.
Data from 378 patients was collected. predicted mortalities were calculated for all patients using the European System for Cardiac Operative Risk Evaluation and different mitral valve procedures were compared with 30-day mortality, length of hospital care and rate of post-operative complications.
The mortality rate in the mitral valve repair (MVP) group decreased gradually from 5.9% (in 1999) to 2.2% (2003). The variation of annual mortality was higher in the mitral valve replacement (MVR) group. The predicted mortality given by Euroscore increased over the years in both groups. The mortality in the MVR group was nearly four times higher than in the MVP group. the length of both intensive and overall hospital stay decreased in patients with MVP procedures. Post-operative survival was 89% in the MVP patients and 74% in mvr patients after three years.
The results of mitral valve operations have improved. This is observed as decreased mortality rates and lengths of hospital care in the MVP group, although the predicted mortality rate was increased.
PubMed ID
18812276 View in PubMed
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Assessment of concomitant paroxysmal atrial fibrillation ablation in mitral valve surgery patients based on continuous monitoring: does a different lesion set matter?

https://arctichealth.org/en/permalink/ahliterature256938
Source
Interact Cardiovasc Thorac Surg. 2014 Feb;18(2):177-81; discussion 182
Publication Type
Article
Date
Feb-2014
Author
Alexandr Bogachev-Prokophiev
Sergey Zheleznev
Alexey Pivkin
Evgeny Pokushalov
Alexander Romanov
Vladimir Nazarov
Alexander Karaskov
Author Affiliation
Heart Valves Surgery Department, State Research Institute of Circulation Pathology, Novosibirsk, Russian Federation.
Source
Interact Cardiovasc Thorac Surg. 2014 Feb;18(2):177-81; discussion 182
Date
Feb-2014
Language
English
Publication Type
Article
Keywords
Atrial Fibrillation - complications - diagnosis - physiopathology - surgery
Cardiac Surgical Procedures - adverse effects
Catheter Ablation - adverse effects
Electrocardiography, Ambulatory
Female
Heart Valve Diseases - complications - diagnosis - surgery
Heart Valve Prosthesis Implantation - adverse effects
Humans
Male
Middle Aged
Mitral Valve - surgery
Predictive value of tests
Prospective Studies
Pulmonary Veins - physiopathology - surgery
Recurrence
Russia
Time Factors
Treatment Outcome
Abstract
The efficacy of concomitant ablation techniques in patients with paroxysmal atrial fibrillation (AF) undergoing mitral valve surgery remains under debate. The aim of this prospective, randomized, single-centre study was to compare pulmonary vein isolation (PVI) only versus a left atrial maze (LAM) procedure in patients with paroxysmal AF during mitral valve surgery.
Between February 2009 and June 2011, 52 patients with a mean age of 54.2 (standard deviation 7.2 years) underwent mitral valve surgery and concomitant bipolar radiofrequency ablation for paroxysmal AF. Patients were randomized into the PVI group (n = 27) and the LAM group (n = 25). After surgery, an implantable loop recorder for continuous electrocardiography (ECG) monitoring was implanted. Patients with an AF burden (AF%) of
PubMed ID
24254537 View in PubMed
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Canadian Cardiovascular Outcomes Research Team. Outcomes after aortic and mitral valve replacement surgery in Canada 1994/2000.

https://arctichealth.org/en/permalink/ahliterature175205
Source
Can J Cardiol. 2005 Mar 15;21(4):374; author reply 374, 7
Publication Type
Article
Date
Mar-15-2005
Author
Michel Carrier
Source
Can J Cardiol. 2005 Mar 15;21(4):374; author reply 374, 7
Date
Mar-15-2005
Language
English
Publication Type
Article
Keywords
Aortic Valve - surgery
Canada
Databases, Factual
Heart Valve Prosthesis Implantation
Hospital Mortality
Humans
Mitral Valve - surgery
Treatment Outcome
Notes
Comment On: Can J Cardiol. 2004 Feb;20(2):155-6315010737
PubMed ID
15838571 View in PubMed
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Canadian Cardiovascular Society atrial fibrillation guidelines 2010: surgical therapy.

https://arctichealth.org/en/permalink/ahliterature136940
Source
Can J Cardiol. 2011 Jan-Feb;27(1):67-73
Publication Type
Conference/Meeting Material
Article
Author
Pierre Pagé
Author Affiliation
Research Center, Hôpital du Sacré-Coeur de Montréal, Montreal, Québec, Canada. pierre.page@umontreal.ca
Source
Can J Cardiol. 2011 Jan-Feb;27(1):67-73
Language
English
Publication Type
Conference/Meeting Material
Article
Keywords
Administration, Oral
Anticoagulants - administration & dosage
Atrial Appendage - surgery
Atrial Fibrillation - etiology - mortality - surgery
Canada
Catheter Ablation
Combined Modality Therapy
Evidence-Based Medicine
Heart Atria - surgery
Heart Diseases - mortality - surgery
Humans
Long-Term Care
Mitral Valve - surgery
Pulmonary Veins - surgery
Reoperation
Survival Rate
Thromboembolism - etiology - mortality - prevention & control
Abstract
Surgery for atrial fibrillation (AF) has been demonstrated as an effective treatment to restore and maintain sinus rhythm in patients for whom a rhythm control strategy is desired. It is usually offered to patients undergoing other types of cardiac surgery (eg, mitral valve repair or replacement, coronary artery bypass grafting, aortic valve surgery, intracardiac defects, ascending aortic surgery). It is also feasible as a stand-alone procedure, bearing a high success rate. In the past few years, less-invasive procedures have been described. AF is a triggered arrhythmia, resulting from ectopic activity most commonly located in and around the pulmonary veins of the left atrium. Therefore, electrical isolation of the pulmonary veins from the rest of the left atrium in order to prevent AF from being triggered is the rationale common to all surgical techniques. Further substrate modification may be required in patients with more persistent AF. This is done by adding ablation of the posterior left atrium with connecting lines of block between pulmonary veins, to the mitral valve annulus, as well as in specific sites in the right atrium. The left atrial appendage is resected or occluded at the same time. Despite patients' high rate of freedom from AF after surgery (70%-85% at 1 year), surgical ablation of AF has never been clearly shown to alter long-term mortality. The available literature supports the recommendation to stop oral anticoagulation therapy 6 months after surgery when sinus rhythm can be documented, because a very low rate of thromboembolic events is reported. However, there is no evidence-based data to support the safety of omitting long-term oral anticoagulation. Thus, surgery should be used primarily as a concomitant procedure during cardiac surgery for other diseased states or as a stand-alone procedure after failure of prior attempts of catheter ablation and antiarrhythmic drugs.
PubMed ID
21329864 View in PubMed
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Clinical and echocardiographic outcomes after repair of mitral valve bileaflet prolapse due to myxomatous disease.

https://arctichealth.org/en/permalink/ahliterature127324
Source
J Thorac Cardiovasc Surg. 2012 Apr;143(4 Suppl):S8-11
Publication Type
Article
Date
Apr-2012
Author
Vincent Chan
Marc Ruel
Sophia Chaudry
Stephane Lambert
Thierry G Mesana
Author Affiliation
Division of Cardiac Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Source
J Thorac Cardiovasc Surg. 2012 Apr;143(4 Suppl):S8-11
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Coronary Artery Bypass
Female
Follow-Up Studies
Heart Valve Prosthesis Implantation - adverse effects - mortality
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Mitral Valve - surgery - ultrasonography
Mitral Valve Annuloplasty - adverse effects - mortality
Mitral Valve Insufficiency - etiology - surgery
Mitral Valve Prolapse - etiology - mortality - surgery - ultrasonography
Ontario
Postoperative Complications - etiology - mortality - surgery - ultrasonography
Predictive value of tests
Recurrence
Reoperation
Time Factors
Treatment Outcome
Abstract
Repair of mitral regurgitation (MR) due to bileaflet prolapse poses many technical challenges. The late outcomes after repair are also not well characterized in this population. Published series have often included patients with mixed causes of prolapse and/or lack long-term echocardiographic follow-up. Myxomatous disease represents an important cause of bileaflet prolapse and MR and, thus, served as the focus of the present study.
A total of 142 patients, mean age 60.4 ± 13.2 years, underwent mitral valve (MV) repair of bileaflet prolapse due to myxomatous disease from 2001 to 2010. Concomitant coronary artery bypass grafting was performed in 16 patients (11%). All patients were followed up by a dedicated MV clinic with a follow-up interval that extended up to 8.6 years.
No hospital deaths occurred. Ring annuloplasty was used for all patients. Additional MV repair techniques included chordal transfer in 73, a hybrid-flip-over technique in 23, polytetrafluoroethylene neochords in 26, edge-to-edge repair in 11, and commissuroplasty in 9. Prolapse involving more than 1 posterior leaflet scallop was observed in 103 patients (73%), and prolapse of more than 1 anterior leaflet scallop was observed in 76 (54%). During follow-up, 4 patients had MR grade 2+ or greater, and 2 patients required subsequent MV reoperation. The 5-year survival, freedom from recurrent MR (= 2+), and freedom from MV reoperation was 95.2% ± 2.8%, 92.6% ± 3.9%, and 94.0% ± 4.9%, respectively.
MV repair of bileaflet prolapse due to myxomatous disease is safe and durable. Successful repair often requires a combination of surgical repair techniques.
PubMed ID
22306213 View in PubMed
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[Comparative study of the results of prosthesis implantation and reconstructive surgery of the mitral valve in congenital insufficiency]

https://arctichealth.org/en/permalink/ahliterature34439
Source
Klin Khir. 1997;(5-6):3-6
Publication Type
Article
Date
1997
Author
M F Zin'kovskii
A A Pishchurin
Author Affiliation
Institut serdechno-sosudistoi khirurgii AMN Ukrainy, g. Kiev.
Source
Klin Khir. 1997;(5-6):3-6
Date
1997
Language
Russian
Publication Type
Article
Keywords
Adolescent
Adult
Child
Child, Preschool
Comparative Study
English Abstract
Female
Heart Valve Prosthesis Implantation
Humans
Infant
Male
Middle Aged
Mitral Valve - surgery
Mitral Valve Insufficiency - congenital - surgery
Abstract
In 23 of 154 patients with congenital mitral valve (MV) insufficiency the MV prosthetics was conducted, and in 23-valve-preserving reconstructive operation. Operative procedures were depicted, early and late follow-up results were analyzed. After the valve-preserving operation conduction hospital lethality was 8.7%, and after the (MV) prosthetics-34.8%. In the late follow-up period after (MV) plastic reconstruction conduction good results were noted in 17 patients, satisfactory-in 1, reoperation was performed in 3 (13%). Application of soft synthetic ring, preventing the dilation of the valve fibrotic ring, may to lower the frequency of reoperation conduction. Plastic correction of the CMVI permits to eliminate the basic haemodynamical disorders and to avoid or postpone the MV prosthetics conduction, what especially important in children.
PubMed ID
9440968 View in PubMed
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Determinants of hospital survival following reoperative single valve replacement.

https://arctichealth.org/en/permalink/ahliterature200134
Source
Can J Cardiol. 1999 Nov;15(11):1207-10
Publication Type
Article
Date
Nov-1999
Author
I S Gill
R G Masters
A L Pipe
V M Walley
W J Keon
Author Affiliation
University of Ottawa Heart Institute, Ottawa, Canada.
Source
Can J Cardiol. 1999 Nov;15(11):1207-10
Date
Nov-1999
Language
English
Publication Type
Article
Keywords
Aged
Aortic Valve - surgery
Cause of Death
Female
Heart Valve Diseases - mortality - surgery
Heart Valve Prosthesis Implantation - mortality
Hospital Mortality
Humans
Intraoperative Complications - mortality
Male
Middle Aged
Mitral Valve - surgery
Ontario - epidemiology
Postoperative Complications - mortality
Reoperation - mortality
Retrospective Studies
Survival Rate
Abstract
To determine the indicators of risk for hospital death, patients undergoing reoperative valve replacement were analyzed
Four hundred and eighteen consecutive patients undergoing reoperative valve replacement from 1977 to 1994 were reviewed using univariate and multivariate analysis.
Overall hospital mortality was 11.2% with 9.4% mortality with aortic valve replacement and 14.2% with mitral valve replacement (P=0.52). Mortality was 9.7% for patients less than 70 years of age compared with 19.4% for older patients (P=0.03), and was 8.5% for those with anoxia times less than 90 mins versus 21.9% for those with longer anoxia times (P=0.001). For first reoperations, 9.5% of patients died, while for patients undergoing second or more reoperation, mortality was 23.2% (P=0.01). While mortality increased from 8.9% to 19.0% with the addition of a concomitant procedure (P=0.008), it was not affected if the additional procedure was a coronary bypass (P=0. 96). The indication for surgery influenced outcome. Mortality was zero for thromboembolism, 9% for structural failure, 23% for nonstructural failure and 22% for endocarditis (P=0.006). For New York Heart Association (NYHA) functional class I patients, mortality was 1.6% compared with 22.3% for those in NYHA class IV (P=0.006). By multivariate analysis, however, only the indication for surgery and the NYHA functional class influenced survival.
Reoperative valve surgery can be performed with a survival (88.8%) that is similar to the initial procedure (91.2%). The indication for surgery and NYHA functional class alone influenced outcome; therefore, possible early reoperation is indicated before clinical deterioration occurs.
PubMed ID
10579733 View in PubMed
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59 records – page 1 of 6.