Long-term results of one-stage surgery of valvularheart diseases and heart rhythm disorders in theremote terms after the operation

Authors: Bockeria L.A., Meladze M.G., Dzhandzhgava D.A., Marganiya G.T.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery of Ministry of Health of the Russian Federation, Rublevskoe shosse, 135, Moscow, 121552, Russian Federation

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Type:  Heart rhythm disorders


DOI: https://doi.org/10.24022/1997-3187-2018-12-1-50-61

For citation: Bockeria L.A., Meladze M.G., Dzhandzhgava D.A., Marganiya G.T. Long-term results of one-stage surgery of valvular heart diseases and heart rhythm disorders in the remote terms after the operation. Creative Cardiology (Kreativnaya Kardiologiya). 2018; 12 (1): 50–61 (in Russ.). DOI: 10.24022/1997-3187-2018-12-1-50-61.

Received / Accepted:  16.07.2017/19.07.2017

Keywords: acquired heart disease heart arrhythmia Maze procedure radiofrequency ablation cryoablation

Full text:  

 

Abstract

Objective. To study long-term results of single-stage surgery of valvular heart disease and heart rhythm disorders.

Material and methods. A total of 117 patients were examined during the study, age at examination varied from 38 to 78 years (median 49 yrs); the period of follow-up after operation was of 5.3±1.9 years. In 75 patients (64.1%), heart diseases were of rheumatic origin: 47 (40.2%) cases of mitral valve insufficiency, 45 (38.5%) – the combined defect of mitral valve, 13 (11.1%) – the combined defect of mitral and aortal valves. Atrial fibrillation (AF) was in 111 (95%) patients and supraventricular tachycardia in 5 cases. Patients were divided into 2 groups: the first one (n=40, operated before 2002) underwent surgical correction of valvular desease, combined with the following procedures: cryoablation / laser ablation / electrical ablation of the atrioventricular node, pacemaker implantation, Sealy's procedure. In the second group (n=77), has been carried out radiofrequency and cryoablation modifications of the Maze procedure.

Results. In the first group sinus rhythm post-operation was observed in 6 (15%) patients, pacemaker rhythm – 33 (82.5%) patients, and AF – 1 (2.5%) patient. In the second group, sinus rhythm – 47 patients (61%), pacemaker rhythm – 21 (27.3%) patients, and atrial rhythm – 9 (11.7%) patients. Own rhythm was less often noted in patients with greater age at surgery (60 years in comparison with 52 years at patients with sinus rhythm), concomitant hypertension, large diameter and volume of the left atrium (54.7 and 50.1 mm respectively), and smaller right ventricle systolic pressure (49 and 36 mm Hg. respectively).

Conclusion. The best results of one-stage surgery of heart valve disease and heart rhythm disorders were noted for the Maze procedure in patients of younger age group, with a smaller left atrium size and smaller right ventricle systolic pressure.

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About Authors

  • Bockeria Leo Antonovich, Academician of Russian Academy of Sciences and Russian Academy of Medical Sciences, Director, orcid.org/0000-0002-6180-2619;
  • Meladze Mayya Guramovna, Junior Researcher;
  • Dzhandzhgava Daredzhan Avtandilovna, Senior Researcher;
  • Marganiya Guram Temurievich, Resident Physician

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery