Artificial valve ring implantation and Cox Maze III procedure in treatment of degenerative mitral annulus dilatation complicated by atrial fibrillation

doi:10.3969/j.issn.2095-4344.2015.52.028

Abstract

Abstract:

BACKGROUND: For patients with degenerative mitral annulus dilatation complicated by atrial fibrillation, atrial fibrillation is needed to be treated concomitant with artificial valve ring implantation. Although Cox maze III procedure is the gold standard for treatment of atrial fibrillation, its safety has been questioned.
OBJECTIVE: To evaluate the safety of artificial valve rings implantation and Cox Maze III procedure for treatment of degenerative mitral annulus dilatation complicated by atrial fibrillation.
METHODS: A total of 43 patients with degenerative mitral annulus dilatation and atrial fibrillation were enrolled and were randomly divided into test group (n=21) and control group (n=22). Patients in the test group were treated with mitral valvuloplasty and Cox Maze III procedure. Patients in the control group were only treated with mitral valvuloplasty.
RESULTS AND CONCLUSION: (1) Intraoperative safety indexes: the durations of cardiopulmonary bypass and aortic clamping. and the incidence of hemoglobinuria in the test group were higher than those in the control group (P < 0.001). There was no significant difference in the urine output between these two groups. (2) Postoperative safety indexes: the incidence of atrial dysrhythmia (i.e., any atrial dysrhythmia other than atrial fibrillation), proportion of patients requiring a temporary pacemaker and hospital stays in the test group were higher than those in the control group (P < 0.05). There were no significant differences in the secondary-thoracotomy bleeding rate and incidence of stroke between these two groups. (3) Postoperative outcomes: the rates of cardioversion to achieve sinus rhythm at the day of surgery and at discharge in the test group were significantly higher than those in the control group (P < 0.001). At discharge, patients in both groups were all at NYHA functional class I or II. Echocardiography showed trace to mild mitral regurgitation and complete closure of the tricuspid valve. There were no significant differences in the left atrial diameter, left ventricular diameter, left ventricular volume, and ejection fraction between these two groups. However, the proportions of mitral and tricuspid valve peak A-waves were significantly higher than those in the control group (P < 0.001). These results show that artificial valve ring implantation and Cox Maze III procedure is a safe and effective method for treating degenerative mitral annulus dilatation complicated by atrial fibrillation during operation.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

CLC Number:

R318

Han Jin-song, Wang Hui-shan, Wang Zeng-wei, Yin Zong-tao, Han Hong-guang, Jin Yan, Liu Yu, Zhao Ke-yan, Yu Yan, Zhao Yang, Chen Zhao-hui. Artificial valve ring implantation and Cox Maze III procedure in treatment of degenerative mitral annulus dilatation complicated by atrial fibrillation[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(52): 8522-8528.

Figures/Tables 7

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