RESUMO
Abstract Objective: To evaluate the factors impacting on the conversion to sinus rhythm and on the postoperative rhythm findings in the six-month follow-up period of a mitral valve surgery combined with cryoablation Cox-Maze III procedure, in patients with atrial fibrillation. Methods: In this study, we evaluated 80 patients who underwent structural valve disease surgery in combination with cryoablation. Indications for the surgical procedures were determined in the patients according to the presence of rheumatic or non-rheumatic structural disorders in the mitral valve as evaluated by echocardiography. Cox-Maze III procedure and left atrial appendix closure were applied. Results: The results of receiver operating characteristics analysis indicated that the rate of conversion to the sinus rhythm was significantly higher in patients with left atrial diameters ≥ 45.5 mm and with ejection fraction (EF) ≥ 48.5%. However, the statistical differences disappeared in the sixth month. Thromboembolic (TE) events were seen only in three patients in the early period and no more TE events occurred in the six-month follow-up period. Conclusion: The EF and the preoperative left atrial diameter were determined to be the factors impacting on the conversion to sinus rhythm in patients who underwent mitral valve surgery in combination with cryoablation. Mitral valve surgery in combination with ablation for atrial fibrillation does not affect mortality and morbidity in the experienced health centers; however, it remains controversial whether it will provide additional health benefits to the patients compared to those who underwent only mitral valve surgery.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Fibrilação Atrial/cirurgia , Fibrilação Atrial/fisiopatologia , Implante de Prótese de Valva Cardíaca/métodos , Criocirurgia/métodos , Frequência Cardíaca/fisiologia , Valva Mitral/cirurgia , Período Pós-Operatório , Valores de Referência , Fibrilação Atrial/prevenção & controle , Fatores de Tempo , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Resultado do Tratamento , Eletrocardiografia , Período Pré-Operatório , Átrios do Coração/cirurgia , Valva Mitral/fisiopatologiaRESUMO
Background: Reperfusion following ischemia can lead to more injuries than ischemia itself especially in diabetic patients. The aim of this study was to evaluate the effect of dexmedetomidine on ischemia-reperfusion injury [IRI] in rats with have hepatic IRI and diabetes mellitus
Methodology: Twenty-eight Wistar Albino rats were randomised into four groups as control [C], diabetic [DC], diabetic with hepatic ischemia-reperfusion injury [DIR], and diabetic but administered dexmedetomidine followed by hepatic IRI [DIRD] groups. Hepatic tissue samples were evaluated histopathologically by semiquantitative methods. Malondialdehyde [MDA], superoxide dismutase [SOD], glutathion s-transpherase [GST], and catalase [CAT] enzyme levels were investigated in liver and kidney tissues as oxidative state parameters
Results: In Group DIR; hepatocyte degeneration, sinusoidal dilatation, pycnotic nucleus, and necrotic cells were found to be more in rat hepatic tissue; while mononuclear cell infiltration was higher in the parenchyme. MDA levels were significantly lower; but SOD levels were significantly higher in Group DIRD with regard to Group DIR. In the IRI induced diabetic rats' hepatic and nephrotic tissues MDA levels, showing oxidative injury, were found to be lower. SOD levels, showing early antioxidant activity, were higher
Conclusion: The enzymatic findings of our study together with the hepatic histopathology indicate that dexmedetomidine has a potential role to decrease IRI?