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Long-term follow up after aortic valve replacement for patients with aortic valve lesion and atrial fibrillation
Shunsuke Sato, Tomoyuki Fujita, Yusuke Shimahara, Hiroki Hata, Junjiro Kobayashi.
National Cerebral and Cardiovascular Center, Osaka, Japan.

OBJECTIVE:
Treatment for patients having non-mitral disease with atrial fibrillation is controversial. Now, we report our clinical results of aortic valve replacement (AVR) for patients with aortic valve lesion and atrial fibrillation in contrast with AVR concomitant with maze procedure.
METHODS:
Eighty-eight patients who had atrial fibrillation and aortic valve disease were enrolled in this study. All underwent AVR in one institution. Thirty-five were performed AVR with left atrial appendage plication (LAAp) and 53 were performed AVR with maze procedure using cryoablation. Warfarin was prescribed for patients who had atrial fibrillation after operation or were used mechanical valve.
RESULTS:
The conversion rate from atrial fibrillation after maze procedure was 94% at 6 months. There were 2 hospital deaths (6%) in AVR with LAA plication group, and 3 (6%) in AVR with maze procedure. Survival rate was 82% in AVR with LAAp versus 92% in AVR with maze procedure at 5 years and 73% versus 83% at 10 years (p=0.322). There were no significant differences of freedom from embolism (p=0.356), hospitalization for heart failure (p=0.129) and cerebral breeding (p=0.159) between groups.
CONCLUSIONS:
There was no difference between the results of AVR with LAAp and AVR with maze procedure. The atrial fibrillation conversion rate was good after AVR with maze procedure using cryoablation.


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