MedStar Authors catalog › Details for: Associations Between Surgical Ablation and Operative Mortality Following Mitral Valve Procedures.
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Associations Between Surgical Ablation and Operative Mortality Following Mitral Valve Procedures.

by Thourani, Vinod H.
Citation: Annals of Thoracic Surgery. 2018 Jan 29.Journal: The Annals of thoracic surgery.Published: 2018ISSN: 0003-4975.Full author list: Rankin JS; Grau-Sepulveda MV; Ad N; Damiano RJ Jr.; Gillinov AM; Brennan JM; McCarthy PM; Thourani VH; Jacobs JP; Shahian DM; Badhwar V.UI/PMID: 29391145.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleOnline resources: Click here to access online Digital Object Identifier: (Click here) Abbreviated citation: Ann Thorac Surg. 2018 Jan 29.Local Holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007.Abstract: BACKGROUND: Surgical ablation (SA) for atrial fibrillation (AF) concomitant to mitral valve repair/replacement (MVRR) improves longitudinal sinus rhythm. However, the risk of adding SA remains a clinical question. This study examined whether the addition of contemporary SA for AF has an impact on operative outcomes.Abstract: METHODS: The study cohort included 88,765 MVRR patients +/- SA, CABG, septal defect, and tricuspid repair in the STS Database between 2011 and 2014. Group 1 did not have AF (No-AF) and did not receive SA (No-SA); Group 2 had No-AF immediately preoperatively but received SA; Group 3 had AF but No-SA; and Group 4 had AF with SA. Groups 3 and 4 were stratified into paroxysmal versus non-paroxysmal AF. Using logistic regression, with Group 1 as reference, risk-adjusted odds ratios (OR) for mortality were compared for SA performance, AF type, and SA technique.Abstract: RESULTS: Group 3 had higher age, NYHA Class, redo operations, and unadjusted mortality than Group 4. Relative to Group 1, Group 3 had an OR for mortality of 1.15 (1.04-1.27;p<0.01). OR increments were similar for paroxysmal and non-paroxysmal AF. In Group 4, concomitant SA was independently associated with lower AF-related relative risk (OR=1.08), to a level that was not different from Group 1 (p=0.13). Observed treatment effects were equivalent for paroxysmal and non-paroxysmal AF, and across all levels of baseline risk.Abstract: CONCLUSIONS: For patients with AF at the time of mitral surgery, the performance of SA seems associated with a lower risk-adjusted operative mortality compared to patients who are not ablated.Abstract: Copyright (c) 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

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