Effects of concomitant atrial fibrillation radiofrequency ablation during aortic valve replacement on surgical risk

Zheng Shuai; Jiao Yuqing; Zhang Haibo; Li Yan; Han Jie; Meng Xu

doi:10.3760/cma.j.issn.1673-4777.2016.04.009

Abstract：Objective To investigate the effects of concomitant atrial fibrillation radiofrequency ablation (RFA) on surgical risk of aortic valve replacement (AVR).Methods A total of 496 consecutive patients with AVR from January 2005 to July 2015 were selected,among them 28 underwent underwent AVR and RFA,468 patients underwent single AVR.After matching with with propensity score matching methods by 1 ∶ 3,28 patients were enrolled in AVR + RFA group and 84 patients were enrolled in AVR group.All procedures were performed under general anesthsia and cardiopulmonary bypass.Patients in AVR + RFA group underwent concomitant left atrial or biatrial RFA during AVR,however,patients in AVR group only underwent valve relacement.The durations of cardiopulmonary bypass,aortic clamp,mechanical ventilation,intensive care unit (ICU) stay and hospital stay after operation,the perioperative adverse events were compared between the two groups.Results The durations of cardiopulmonary bypass and aortic clamp in AVR + RFA group were significantly longer than those in AVR group [(93 ±61) min vs (59 ±45) min,(65 ±40) min vs (40 ±30) min] (P ＜0.05).However,there were no significant differences in durations of mechanical ventilation,ICU stay and hospital stay after operation between groups [14 (5,18) h vs 8 (4,18) h,17 (8,32) h vs 16 (6,21) h,(7.0 ±2.4) d vs (7.5 ±3.0) d] (all P＞0.05).No stroke,dialysis for renal failure,death and readmission occurred within 30 days after operation in both groups;the incidences of perioperative adverse reactions were not significantly different between groups [ventilator assisted time ＞ 24 h:10.7％ (3/28) vs 6.0％ (5/84),opening stanching:3.6％ (1/28)vsO.0％ (0/84)] (P＞0.05).Conclusion Concomitant RFAduring AVR does not increase the surgical risk and has good safety.