Key result
The biatrial approach to mitral valve surgery resulted in a predictable loss of sinus mechanism, with only 3 of 22 patients admitted in normal sinus rhythm remaining in this rhythm at discharge.
Why the study?
Does a biatrial approach to mitral valve surgery cause loss of normal sinus rhythm in patients undergoing the procedure?
Cohort (n=38)
Does a biatrial approach to mitral valve surgery cause loss of normal sinus rhythm in patients undergoing the procedure?
The biatrial approach to mitral valve surgery is associated with a high rate of sinus node dysfunction and loss of normal sinus rhythm, suggesting its routine use requires careful reconsideration.
Biatrial mitral surgery may associate with high sinus node dysfunction risk; Level 5 data leaves open optimal approach selection.
The biatrial approach to exposing the mitral valve during surgery has the potential for improving visualization of the valve with minimal cardiac manipulation. This procedure, involving a right atriotomy and an extended transseptal incision, may isolate the sinus node from its normal blood supply and autonomic innervation. Thirty-eight consecutive patients undergoing this procedure were examined. Twenty-two of these patients (58%) were admitted in normal sinus rhythm and 15 (40%) were in atrial fibrillation (AF) or atrial flutter. Of the 22 patients admitted in normal sinus rhythm, only 3 patients remained in this rhythm at discharge. Fourteen of the 22 patients were discharged in a slow, low atrial rhythm. All of the patients admitted in AF were discharged in AF. Of the 14 patients discharged in a low atrial rhythm, the rhythm persisted in eleven patients (80%) at a mean of 6-month follow-up. The routine use of this transseptal approach to mitral valve surgery needs further assessment in light of the predictable loss of the sinus mechanism.
No takes yet. Share an insight, caveat, or question.
Bernstein et al. (1996) conducted a cohort in Mitral valve surgery (n=38). Biatrial approach to mitral valve surgery was evaluated on Maintenance of normal sinus rhythm at discharge. The biatrial approach to mitral valve surgery resulted in a predictable loss of sinus mechanism, with only 3 of 22 patients admitted in normal sinus rhythm remaining in this rhythm at discharge.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: