1. [Cryoablation of pulmonary veins as complementary treatment of atria I fibrillation in valvular surgery].
- Author
-
Zalaquett S R, Pérez A E, Garayar P B, Vergara S I, Moran V S, Becker R P, Irarrázaval Ll MJ, and Ochoa T R
- Subjects
- Adult, Aged, Atrial Fibrillation mortality, Cardiac Surgical Procedures mortality, Catheter Ablation mortality, Female, Follow-Up Studies, Heart Atria surgery, Heart Valve Prosthesis Implantation, Humans, Male, Middle Aged, Treatment Outcome, Atrial Fibrillation surgery, Cardiac Surgical Procedures methods, Catheter Ablation methods, Cryosurgery methods, Pulmonary Veins surgery
- Abstract
Background: The Cox MAZE III operation for the treatment of atrial fibrillation (AF) is complex and consumes significant operative time. Cryoablation of the pulmonary veins (CPV) is a simpler alternative for patients that require concomitant valvular surgery., Aim: To evaluate CPV in patients with AF submitted to valvular surgery., Patients and Methods: Twenty one patients had simultaneous valvular surgery and CPV, 81 % of them had permanent AF for an average of 5 years. Twenty patients had mitral valve disease. The etiology was rheumatic in 14. Average left atrial diameter was 60 mm. In 7 patients the mitral valve was replaced, in 5 it was repaired, in 7 both mitral and aortic valve were replaced, in 1 the mitral valve was repaired and the aortic valve was replaced and in 1 only the aortic valve was replaced. A combined transeptal and superior approach was used for all patients. The CPV was performed after the valvular procedure with cryothermy at -60 degrees C for 2 minutes with two 15 mm cryoprobes applied simultaneously., Results: CPV increased surgical time by 10 to 20 minutes. Operative mortality was 4.8% (1 patient). One patient developed a pericardial effusion and another a complete heart block that required a permanent pacemaker. All patients improved their functional class. At the end of an average 10.5 months of follow-up, 50% of patients were in normal sinus rhythm and 25% persisted in AF. The remaining patients were in some type of regular rhythm., Conclusions: CPV as a complementary procedure in patients with AF undergoing valvular surgery had good results to abate AF. It restored normal sinus rhythm in 50% of the cases, with low morbidity and mortality and little increment in surgical time.
- Published
- 2007
- Full Text
- View/download PDF