Mid-term follow-up of rheumatic mitral valve repair combined with atrial fibrillation ablation

MP030 

Abstract Submission 

Zhiwei Xu (1), lijuan zhang (2)

(1) Huai'an First People's Hospital The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huaian, China, (2) Department of Cardiac Surgery, Huai’an First People’s Hospital, The Affifiliated Huai’an No. 1 Peop, huai'an, NA

Zhiwei Xu    -  Contact Me
Huai'an First People's Hospital The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University

lijuan zhang    -  Contact Me
Department of Cardiac Surgery, Huai’an First People’s Hospital, The Affifiliated Huai’an No. 1 Peop

Zhiwei Xu    -  Contact Me
Huai'an First People's Hospital The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University

Objective: Rheumatic heart disease (RHD) is the leading cause of mitral valve disease in the developing world. Most of these rheumatic heart disease patients also have concomitant atrial fibrillation. Mitral repair is feasible for patients with degenerative or ischemic heart disease, however, the appropriateness of repair for rheumatic heart disease remains controversial. Its results in the rheumatic valve are not as successful as that for degenerative repair. Also the efficacy of atrial fibrillation ablation in rheumatic mitral valve disease has been regarded inferior to that in nonrheumatic diseases. Our approach has been to repair rheumatic mitral valves concomitant atrial fibrillation ablation, and we aimed by this study to present our immediate and midterm follow-ups of our cohort of rheumatic valve repair patients concomitant atrial fibrillation ablation.

Methods: From September 2019 to December 2022, 38 consecutive rheumatic mitral valve patients with persistent atrial fibrillation underwent mitral valve repair concomitant atrial fibrillation ablation. The mitral valve repair was done with the 4-step commisuroplasty SCORe procedure. The ablation line was done with the Cox procedure.

Results: These patients mean age was 45.92±11.81 years. The study population was 81.6% female. Twenty-nine patients were in New York Heart Association functional class III or IV. The repair techniques were performed in 4 steps in general and mainly based on commissuroplasty; tricuspid repair with Carpentier-Edwards Classic tricuspid annuloplasty ring in 36 (94.7%) patients, the Cox procedure with Medtronic ablation clamp in all 38 patients. There was no operative mortality. They were followed up for a median of 23.5 months (Average 25.2±11.5 months). Mitral valve orifice area (MVOA) was less than 1.5 cm2, and mean (SD) MVOA for the whole cohort was 1.20 (0.34) cm2 preoperative. The mobility of the anterior leaflet was improved (P < .001) during the cardiac cycle postsurgery, but that of the posterior leaflet was not (P = .591). The mean (SD) coaptation length was increased significantly from 6.69 (1.32) mm to 7.92 (1.24) mm (P < .001) postoperatively. M

Rheumatic Mitral Valve Disease