Key result
The trans-septal approach for mitral valve replacement was associated with a significantly higher incidence of postoperative atrial fibrillation compared to the left atrial approach (42.67% vs. 13.33%).
Why the study?
Despite improved mitral valve exposure with the trans-septal approach, it has been associated with increased risks of postoperative AF and other complications compared to the left atrial approach.
Does the trans-septal approach increase postoperative atrial fibrillation compared to the left atrial approach in patients undergoing mitral valve replacement for rheumatic mitral lesions?
Cohort (n=180)
No
Does the trans-septal approach increase postoperative atrial fibrillation compared to the left atrial approach in patients undergoing mitral valve replacement for rheumatic mitral lesions?
Absolute Event Rate: 42.67% vs 13.33%
p-value: p=<0.001
The trans-septal approach for mitral valve replacement in rheumatic disease is associated with a significantly higher risk of postoperative atrial fibrillation and longer hospital stays compared to the left atrial approach.
May warrant caution with trans-septal approach due to higher AF risk; leaves open need for randomized trials in rheumatic mitral replacement.
Background: Mitral valve replacement (MVR) is a common surgical intervention for rheumatic mitral valve disease, with two widely used surgical approaches: left atrial (LA) and trans-septal (TS) approaches. Despite improved exposure of mitral valve in TS approach, it has been associated with an increased risk of postoperative atrial fibrillation (AF) and other complications. This study aims to compare postoperative outcomes, including AF, between LA and TS approaches in patients undergoing MVR for rheumatic mitral lesions. Methods: A retrospective study was conducted on 180 patients who underwent MVR for rheumatic mitral lesions at Tanta University Hospitals between 2017 and 2021. patients were grouped into two matched cohorts (n=75 each) based on propensity score: Group A (TS approach) and Group B (LA approach). Data on demographic characteristics, intraoperative details, and postoperative outcomes, including incidence of AF, were collected. Results: Patients in TS group had significantly longer intubation durations (20.4 ± 2 vs. 13.1 ± 1.46 hours, p < 0.001), ICU stays (4 ± 0.83 vs. 1.9 ± 0.81 days, p < 0.001), and hospital stays (12.1 ± 2.07 vs. 9.3 ± 1.78 days, p < 0.001). Postoperative AF occurred more frequently in TS group (42.67% vs. 13.33%, p < 0.001).
No takes yet. Share an insight, caveat, or question.
Morsy et al. (2021) conducted a cohort in Rheumatic mitral valve lesion (n=180). Trans-septal (TS) approach vs. Left atrial (LA) approach was evaluated on Postoperative atrial fibrillation (p=<0.001). The trans-septal approach for mitral valve replacement was associated with a significantly higher incidence of postoperative atrial fibrillation compared to the left atrial approach (42.67% vs. 13.33%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: