Thorac Cardiovasc Surg 2016; 64(05): 441-446
DOI: 10.1055/s-0035-1558993
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Effect of Left Atrial Reduction on Restoration and Maintenance of Sinus Rhythm in Patients Undergoing Mitral Valve Replacement: A Pilot Study

Adnan Yalcinkaya
1   Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey
,
Adem Ilkay Diken
2   Hitit University Corum Education and Research Hospital, Department of Cardiovascular Surgery, Corum, Turkey
,
Eray Aksoy
3   Kartal Kosuyolu Education and Research Hospital, Department of Cardiovascular Surgery, Istanbul, Turkey
,
Gokhan Lafci
1   Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey
,
Omer Faruk Cicek
1   Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey
,
Ersin Kadirogullari
1   Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey
,
Umit Deniz Ulusar
4   Akdeniz University, Faculty of Engineering, Department of Computer Engineering, Antalya, Turkey
,
Kerim Cagli
1   Turkey Yuksek Ihtisas Education and Research Hospital, Department of Cardiovascular Surgery, Ankara, Turkey
› Author Affiliations
Further Information

Publication History

27 February 2015

12 June 2015

Publication Date:
20 August 2015 (online)

Abstract

Background This pilot study aimed to evaluate the effectiveness of posterior left atrial wall plication (T-plasty) in patients with persistent atrial fibrillation (AF) (> 7 days) undergoing mitral valve surgery.

Materials and Methods A total of 60 patients who were scheduled for mitral valve replacement were randomly allocated into two groups: one would receive (Group 1; n = 32, mean age; 49.37 ± 9.00) and one would not receive (Group 2; n = 28; mean age 48.64 ± 8.6) left atrial size reduction using T-plasty technique. Patients with a clear indication for combined procedures other than tricuspid valve disease, aortic valve disease, and coronary artery stenosis were not included. Follow-up was performed at 6th, 12th, and 18th months after the operation.

Results After the operation, 21 patients (65.6%) in Group 1 and 13 patients (46.4%) in Group 2 regained sinus rhythm (p = 0.13). Mortality did not occur. AF recurrence rates were not significantly different between the groups in three follow-ups. Restoration of sinus rhythm was significantly more common in Group 1 patients than in Group 2 patients during follow-up. Patients in Group 1 had lower left atrial volume indexes than those in Group 2 at the 6th and 12th months, whereas the difference at the 18th month was at the limit of significance.

Conclusion We achieved satisfactory results using the T-plasty technique for left atrial size reduction in terms of mid-term restoration and preservation of normal sinus rhythm in patients undergoing mitral valve surgery. Further study may be justified to reveal the prognostic importance of the technique described herein.

 
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