Observation on heart valve replacement combined with radiofrequency ablation in treatment of cardiac valve disease

Hang Yongbin; Li Gang; Wang Shuwei; Cao Junying; Zhou Li; Xu Yanbin; Liang Qiang

doi:10.3969/j.issn.1672-8521.2017.02.006

Abstract：Objective:To evaluate the treatment effects of cardiac valve replacement combined with radiofrequency ablation in treatment of cardiac valve disease.Methods:Seventy-five patients with cardiac valve disease admitted to the 153rd Central Hospital of PLA from Mar.2013 to Feb.2016 received cardiac valve replacement treatment.All the patients were with heart function of ≥ Ⅲ NYHA grade,of them 51 cases were treated with heart valve replacement combined with bipolar radiofrequency ablation (bipolar group,26 cases) or with unipolar radiofrequency ablation (unipolar group,25 cases),and 24 cases were treated only with cardiac valve replacement (control group).The time of radiofrequency ablation treatment,the recovery of sinus rhythm immediate postoperation,the assisted respiration time,the time of postoperative hospital stay,perioperative mortality and the improvement of cardiac function were compared between bi-and unipolar groups vs.control group.Results:Compared between bi-and unipolar groups vs.control group,the recovery rates of sinus rhythm immediate postoperation were 92.31％ and 88.00％ vs.70.83％,the assisted respiration time presented (16.75+2.68) hours and (16.04+4.21) hours vs.(24.81±3.38) hours,the time of postoperative hospital stay spent (8.41±1.84) days and (9.01±1.72) days vs.(11.26±2.35) days;As for the cardiac function indexes,the left ventricular end-diastolic dimension in 6 months were (47.24±5.81) mm and (46.03±6.78) mm vs.(53.11±4.35) mm and in 12 months were (41.84±3.69) mm and (40.98±5.27) mm vs.(48.75±4.36) mm,the left ventricular ejection fraction in 6 months were 0.483 6±0.027 9 and 0.495 1±0.030 2 vs.0.433 2±0.037 2 and in 12 months were 0.580 4±0.038 5 and 0.569 3±0.029 6 vs.0.489 1±0.038 1,the pulmonary artery systolic pressure in 6 months were (39.82±3.42) mmHg and (40.21±2.01) mmHg vs.(44.92±2.44) mmHg and in 12 months were (35.62±2.11) mmHg and (36.63±1.92) mmHg vs.(39.95±2.87) mmHg,and the total effective rates of heart function were 88.46％ and 84.00％ vs.54.17％ (all P ＜ 0.05).The indexes mentioned-above showed no significant difference between bipolar group and unipolar group (P ＞ 0.05),but the time of ablation treatment was shorter in bipolar group [(22.34±2.57) minutes] than in unipolar group [(29.04±3.41) minutes,P＜0.05].Conclusions:Cardiac valve replacement combined with radiofrequency ablation is beneficial to improve the prognosis of heart valve disease,and bipolar radiofrequency ablation is superior to unipolar radiofrequency ablation in effectiveness and safety.