The influence of left atrial auricle bandaging on the restoration of sinus rhythm of patients with mitral valve diseases and persistent atrial fibrillation
Objective. Analyze the impact of the left atrial (LA) appendage ligation during mitral valve surgery in the restoration and maintenance of sinus rhythm (SR) in patients with persistent atrial fibrillation (AF). Methods. 142 patients with AF who underwent mitral valve (MV) surgery under using cardiopulmonary bypass (CPB) in 2007-2012 were analized. Mean age was 54,1±0,6 years, 56 men (39.4%), 86 women (60.6%). Isolated MV disease (MVD) had 57 (40.1%) patients, in 53 (37.3%) patients it was combined with tricuspid valve (TV) disease, in 16 (11.3%) with aortic valve (AV) disease, 16 (11.3%) patients had triple valve lesion. The average duration of the arrhythmia was 41±6 months. The patients were divided into two groups. Group I included 46 patients who underwent ligation LA appendage (LAA) during surgery. In group II included 96 patients with LAA was left intact. Results. Intraoperative recovery SR in group I was in 29 (63.0%) patients, in group II – in 50 (52,1%) (p=0,109). At the time of discharge, SR remained in 15 (32.6%) and 9 (9,4%) (p=0.002) patients, respectively. Conclusion. Spontaneous recovery and maintenance of SR in patients with persistent atrial fibrillation in the surgical correction of MVD without isolation of the PVs is possible in 17% of patients. Performing ligation LAA significantly increases the chance of SR maintenance more than 5 times in this group of patients. Reproducibility and safety of ligation LAA allows to recommend the procedure in all cases of MVD surgery.