| Objective: To analyze the effects of atrial fibrillation course on the safety and early efficacy of complete maze of radiofrequency ablation during mitral valve surgery in elderly patients over 70 years of age with degenerative mitral valve closure combined with atrial fibrillation.Methods: Retrospective analysis was used to analyze the clinical data of 60 elderly patients over 70 years of age with degenerative mitral valve closure combined with atrial fibrillation who underwent mitral valve surgery at the Shenyang Military Region General Hospital from 2006 to 2010 and performed a full maze of bipolar radiofrequency ablation at the same time.The patients were divided into 3 groups according to the course of preoperative atrial fibrillation:group A,18 cases of atrial fibrillation duration < 1 years,male 7 cases,female 11 cases,age(73.44±1.95);group B,17 cases of atrial fibrillation duration 1~5 years,male9 cases,female 8 cases,age(75.06±2.66);group C,the duration of atrial fibrillation.5 years,25 cases,male 11 cases,female 14 cases,age(74.68±2.32)years old;Through the comparison of the operation between 3 groups of related data(operation time,cardiopulmonary bypass time,aortic clamping time,the use of temporary pacemaker after surgery),postoperative recovery(anesthesia recovery time,postoperative ventilator carried time and postoperative cardiac function,hospitalization time,etc.)on the indexes of echocardiography in the postoperative(left atrium diameter,postoperative left ventricular volume,postoperative LVEF(ejection fraction)etc.),differences in mortality,postoperative hospitalization time,evaluate the effect of atrial fibrillation course on the safety of retrogressive mitral valve closure combined with atrialfibrillation in aged over 70 years of age undergoing complete maze double pole radiofrequency ablation.Through the comparison of 3 groups of patients before and after each index(NYHA grade of heart function,left atrial diameter and postoperative left ventricular diameter,postoperative LVEF,mitral regurgitation,etc.)between the 3groups of patients were discharged,3 months after surgery,6 months after the operation and after 1 years of atrial fibrillation cardioversion differences,evaluate the effect of atrial fibrillation course on the early curative effect of complete maze double pole radiofrequency ablation for retrogressive mitral valve closure and atrial fibrillation over 70 years of age.Results: Comparison of 3 groups of operative data showed that there was no significant difference in the total operative time,aortic clamping time,bypass time and the proportion of hemoglobinuria in different atrial fibrillation duration(P>0.05).The postoperative recovery of patients with different AF courses was compared: recovery time after anesthesia,postoperative respirator assisted breathing time,antiarrhythmic drugs application(P>0.05)were not statistically significant.The difference between the3 groups in postoperative ICU time,postoperative 24 hours,pericardial drainage fluid,postoperative length of stay and postoperative EF was statistically significant(P<0.05)..After radiofrequency ablation,there were no new cerebral infarction,no two chest hemostatic,no low cardiac output syndrome,no death,and other complications after radiofrequency ablation in the 3 groups.3 groups of patients at discharge,3months after operation,6 months after operation and 1 years after operation,the conversion rate of sinus rhythm in group A was 100%,100%,100% and 94.4%respectively,while those in group B were88.2%,88.2%,76.5% and 76.5%respectively,and those in group C were84%,80%,68% and 60% respectively.Conclusion: Dipolar radiofrequency ablation may be safe in patients with degenerative mitral valve closure and atrial fibrillation over the age of 70,and the course of atrial fibrillation may not be the main factor affecting the recurrence of atrial fibrillation in such patients. |
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