18772
document
Atrial remodeling after mitral valve surgery in patients with permanent atrial fibrillation . BACKGROUND Mitral valve pathology is frequently associated with auricular dilatation and atrial fibrillation . Mitral surgery allows an immediate surgical auricular remodeling and besides in those cases in which sinus rhythm is reached , it is followed by a late remodeling . The aim of this study is to investigate the process of postoperative auricular remodeling in patients with permanent atrial fibrillation undergoing mitral surgery . METHODS In a prospective randomized trial , 50 patients with permanent atrial fibrillation and dilated left atrium , submitted to surgical mitral repair , were divided into two groups : Group I contained 25 patients with left auricular reduction and mitral surgery , and Group II contained 25 patients with isolated valve surgery . Both groups were considered homogeneous in the preoperative assessment . RESULTS After a mean follow-up of 31 months , 46 % of patients included in Group I versus 18 % of patients included in Group II restarted sinus rhythm ( p = 0.06 ) . An auricular remodeling with size regression occurred in those patients who recovered from sinus rhythm , worthy of remark in Group II ( -10.8 % of left auricular volume reduction in Group I compared to -21.5 % in Group II ; p < 0.05 ) . A new atrial enlargement took place in those patients who remained with atrial fibrillation ( +16.8 % left auricular volume in Group I vs. +8.4 % in Group II ; p < 0.05 ) . CONCLUSIONS Mitral surgery produces an atrial postoperative volume that decrease especially when reduction techniques are employed . Late left atrial remodeling depended on the type of atrial rhythm and postoperative surgical volume .
18773
Intervention_Surgical
Atrial remodeling
18774
Intervention_Surgical
mitral valve surgery
18775
Intervention_Surgical
Mitral surgery
18776
Intervention_Surgical
mitral surgery
18777
Intervention_Surgical
left auricular reduction
18778
Intervention_Surgical
mitral surgery
18779
Intervention_Surgical
isolated valve surgery
18780
Outcome_Physical
Atrial remodeling
18781
Outcome_Physical
sinus rhythm
18782
Outcome_Physical
auricular remodeling with size regression
18783
Outcome_Physical
new atrial enlargement
18784
Outcome_Physical
atrial rhythm
18785
Outcome_Physical
postoperative surgical volume
18786
Participant_Condition
permanent atrial fibrillation
18787
Participant_Condition
permanent atrial fibrillation
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Participant_Sample-size
50
18789
Participant_Condition
permanent atrial fibrillation
18790
Participant_Condition
dilated left atrium
18791
Participant_Sample-size
25
18792
Participant_Condition
left auricular reduction and mitral surgery
18793
Participant_Condition
isolated valve surgery