Risk factors related to death during mitral valve replacement and concurrent radiofrequency ablation for atrial fibrillation
Li Si
Wu Xinxin
Chen Xinhao
Yan Dan
Ren Jinyu
He Jigang
Abstract：Objective To discuss the risk factors related to death during cardiac surgery and concurrent radiofrequency ablation(RFA)for atrial fibrillation(AF).Methods The patients with mitral stenosis complicated by AF(n=90)were chosen from Department of Cardiovascular Surgery in the First People's Hospital of Yunnan Province from Jan.2003 to Jan.2023,and were received mitral valve replacement and concurrent RFA for AF.According to surgical results,the patients were divided into successful surgery group(ni=70)and postoperative death group(n=20).The preoperative baseline materials were collected in 2 groups,including gender,age,with or without history of hypertension,diabetes,stroke[or transient ischemic attack(TIA)]smoking,and chronic obstructive pulmonary disease(COPD),AF types[persistent atrial fibrillation(PeAF),permanent AF],grades of NYHA heart function classification(NYHA grades),ejection fraction(EF),left atrial size,preoperative severity of pulmonary arterial hypertension(PAH),preoperative platelet count(PLT),hemoglobin(Hb)content,and cardiac arrest time of aortic occlusion during the surgery.All preoperative and intraoperative data were analyzed statistically by using independent sample t-test and single-factor Logistic regression analysis to determine risk factors for death during cardiac surgery and concurrent RFA.Results There were no significant differences in gender,age and history of hypertension,diabetes,stroke(or TIA),smoking and complicated COPD between 2 groups(P＞0.05).The percentages of patients with permanent AF,NYHA grade Ⅱ or above and EF≤45％(P＜0.05),left atrial diameter(LAD)＞6 mm,and preoperative PAH＞50 mmHg and 60 g/L≤Hb content＜80 g/L(P＜0.05),and cardiac arrest time＞100 min during the surgery(P＜0.05)were higher in successful surgery group than those in postoperative death group.The results of single-factor Logistic regression analysis showed that permanent AF,NYHA grade Ⅱ or above,EF ≤45％,LAD＞6 mm,preoperative PAH＞50 mmHg and 60 g/L≤Hb content ≤80 g/L and cardiac arrest time＞100 min were correlated to death during cardiac surgery and concurrent RFA for AF.Conclusion The factors of permanent AF,NYHA grade Ⅱ or above,EF≤45％,LAD＞6 mm,preoperative PAH＞50 mmHg and Hb content≤80 g/L,and cardiac arrest time＞100 min can increase death risk during the operation.When preoperative and intraoperative indexes reach the above targets,it is recommended to carefully consider performing concurrent RFA for AF during cardiac surgery.
Keywords：Atrial fibrillationSurgeryDeathRisk factors
Publication Date：2024-11-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 1300-1302,1305 )