Left Atrial and Left Ventricular Diastolic Function After the Maze Procedure for Atrial Fibrillation in Mitral Valve Disease: Degenerative Versus Rheumatic |
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Authors: | Hwan Wook Kim Mi Hyoung Moon Keon Hyun Jo Hyun Song Jae Won Lee |
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Affiliation: | .Department of Thoracic and Cardiovascular Surgery, Seoul St. Mary’s Hospital, School of Medicine, The Catholic University of Korea, 505 Banpo-dong, Seocho-gu, Seoul, 137-701 Republic of Korea ;.Department of Thoracic and Cardiovascular Surgery, Seoul Asan Hospital, School of Medicine, The University of Ulsan, 388-1 Pungnap-dong, Songpa-gu, Seoul, 138-736 Republic of Korea |
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Abstract: | The present study was aimed to compare the left atrial and left ventricular diastolic functions amongst the rheumatic and degenerative mitral valve disease patients in atrial fibrillation who reverted to normal sinus rhythm following Cox-maze procedure. We prospectively investigated the left atrial and left ventricular function with Doppler echocardiography, by dividing into the rheumatic (N = 105) and the degenerative group (N = 47). Over the follow-up period (mean: 4.4 ± 1.2 years in the rheumatic group, 4.8 ± 1.3 years in the degenerative group), the rheumatic group showed statistically significant decrease in A'' velocity and E'' velocity, on contrary to degenerative group (A'' velocity: mean decrease of 0.43 ± 0.13 cm/s in the rheumatic group, mean increase of 0.57 ± 0.11 cm/s in the degenerative group, p = 0.029, E'' velocity: mean decrease of 0.23 ± 0.17 cm/s in the rheumatic group, mean increase of 0.21 ± 0.15 cm/s in the degenerative group, p = 0.031). In addition, the rheumatic group showed statistically significant increase in E/E'' ratio than the degenerative group (mean increase of 4.49 ± 1.98 in the rheumatic group, mean increase of 1.74 ± 1.52 in the degenerative group, p = 0.047). Despite successful sinus rhythm restoration, the progressive loss of LA function as well as LV diastolic function is more prominent in the rheumatic group than the degenerative group. Therefore, differentiated strategies for postoperative surveillance are needed according to the pathology of mitral valve disease. |
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Keywords: | Left atrial function Left ventricular diastolic function Maze Degenerative Rheumatic |
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