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Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
- Source :
- Revista médica de Chile v.135 n.7 2007, SciELO Chile, CONICYT Chile, instacron:CONICYT
- Publication Year :
- 2007
- Publisher :
- Sociedad Médica de Santiago, 2007.
-
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 AFfor 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 7patients 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°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
- Subjects :
- Fibrillation
Aortic valve
Heart valves
medicine.medical_specialty
business.industry
medicine.medical_treatment
Cryoablation
General Medicine
Atrial fibrillation
Cryosurgery
Surgery
medicine.anatomical_structure
Mitral valve
Internal medicine
medicine
Cardiology
cardiovascular system
cardiovascular diseases
medicine.symptom
business
Subjects
Details
- Language :
- Spanish; Castilian
- Database :
- OpenAIRE
- Journal :
- Revista médica de Chile v.135 n.7 2007, SciELO Chile, CONICYT Chile, instacron:CONICYT
- Accession number :
- edsair.doi.dedup.....abec9abef685300622ec6d9b99c48da5