Atrial Contraction After Surgical Isolation of the Left Atrial Posterior Wall Concomitant With Mitral Valve Replacement

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Background Surgical isolation of the left atrial posterior wall (LA-PW isolation) can terminate chronic atrial fibrillation associated with mitral valve disease. However, atrial contraction after LA-PW isolation has not been evaluated. Methods and Results The study group comprised 14 patients (mean age, 63±14 years) with mitral valve disease who recovered and maintained regular sinus rhythm after LA-PW isolation. Before the procedure, and 2-3 weeks and 1 year after the LA-PW isolation, the patients underwent an echocardiographic study. The left atrial (LA) diameter decreased after the LA-PW isolation and the change became significant 1 year later (before: 50.1±5.1 mm, after 2-3 weeks: 46.0±4.9mm; p<0.05, after 1 year: 44.0±6.1 mm; p<0.05 vs before the operation). The left ventricular (LV) end-diastolic diameter, LV ejection fraction and LV fractional shortening did not change significantly from before the LA-PW isolation and after 1 year. The time-velocity integral of the atrial wave (Ai) and atrial filling fraction significantly increased (Ai: 4.5±2.1 cm vs 5.8±2.3 cm; p<0.05; atrial filling fraction: 15.4±7.7% to 19.2±8.3%; p<0.05) during the follow-up period. Conclusion LA-PW isolation can benefit the restoration of regular sinus rhythm and, furthermore, the recovery of atrial contraction.
社団法人日本循環器学会の論文
2004-02-20