Double atrial ablation with monopolar irrigated radiofrequecy for atrial fibrillation during minimally invasive mitral valve surgery via right thoracotomy: A clinical controlled study / 第二军医大学学报

ABSTRACT

Objective: To evaluate the safety and efficacy of radiofrequecy ablation for atrial fibrillation during minimally invasive mitral valve surgery via right thoracotomy. Methods: From Jan. 2008 to Dec. 2011, 30 patients underwent radiofrequecy Maze EI procedure for atrial fibrillation during mini-invasive mitral valve surgery (study group). Another 30 patients with atrial fibrillation undergoing mitral valve surgery through median sternotomy without Maze procedure during the same period were taken as controls. The pre-treatment data of the patients were matchable between the two groups. The study group received mitral valve repair/replacement and radiofrequecy Maze HI procedure for atrial fibrillation. The operative outcome, postoperative complication and elimination rate of atrial fibrillation were compared between the two groups. Results: No patient in the study group was transferred to median sternotomy during operation, and there was no reoperation, prolonged incubation, failure of important organs, hemoglobinuria or death. Compared with the control group, the study group had significantly longer mean circulation arrest time and cardiopulmonary bypass time, significantly reduced chest drainage and blood transfusion volume, and significantly shortened hospital study (P<0. 05). The elimination rates of atrial fibrillation at immediately after operation,discharge and 6 months after operation were 96. 7%, 66. 7% and 73. 3% in the study group, and 50%, 23. 3% and 16. 7% in the control group, respectively, with significant difference found between the two groups (P< 0.01). Compared with the control group, better heart function recovery was achieved in the study group at 6 month after operation. Conclusion: Radiofrequecy ablation for atrial fibrillation during minimally invasive mitral valve surgery via right thoracotomy is safe and effective. Importantly, it does not increase risks and complications of surgery. The early and middle term effects are satisfactory.