Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular

Background: The Cox MAZE III operation for the treatment of atrial fibrillation (AF) is complex and consumes significant operative time. Cryoablation of the pulmonary veins (CPV) is a simpler alternative for patients that require concomitant valvular surgery. Aim: To evaluate CPV in patients with AF...

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Autores principales:	Zalaquett S,Ricardo, Pérez A,Erika, Garayar P,Bernardita, Vergara S,Ismael, Moran V,Sergio, Becker R,Pedro, Irarrázaval Ll,Manuel J, Ochoa T,Renato
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2007
Materias:	Atrial fibrillation Cryosurgery Heart valves
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000700007
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spelling	oai:scielo:S0034-988720070007000072007-09-06Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvularZalaquett S,RicardoPérez A,ErikaGarayar P,BernarditaVergara S,IsmaelMoran V,SergioBecker R,PedroIrarrázaval Ll,Manuel JOchoa T,Renato Atrial fibrillation Cryosurgery Heart valves Background: The Cox MAZE III operation for the treatment of atrial fibrillation (AF) is complex and consumes significant operative time. Cryoablation of the pulmonary veins (CPV) is a simpler alternative for patients that require concomitant valvular surgery. Aim: To evaluate CPV in patients with AF submitted to valvular surgery. Patients and Methods: Twenty one patients had simultaneous valvular surgery and CPV, 81 % of them had permanent AFfor an average of 5 years. Twenty patients had mitral valve disease. The etiology was rheumatic in 14. Average left atrial diameter was 60 mm. In 7patients the mitral valve was replaced, in 5 it was repaired, in 7 both mitral and aortic valve were replaced, in 1 the mitral valve was repaired and the aortic valve was replaced and in 1 only the aortic valve was replaced. A combined transeptal and superior approach was used for all patients. The CPV was performed after the valvular procedure with cryothermy at -60°C for 2 minutes with two 15 mm cryoprobes applied simultaneously. Results: CPV increased surgical time by 10 to 20 minutes. Operative mortality was 4.8% (1 patient). One patient developed a pericardial effusion and another a complete heart block that required a permanent pacemaker. All patients improved their functional class. At the end of an average 10.5 months of follow-up, 50% of patients were in normal sinus rhythm and 25% persisted in AF. The remaining patients were in some type of regular rhythm. Conclusions: CPV as a complementary procedure in patients with AF undergoing valvular surgery had good results to abate AF. It restored normal sinus rhythm in 50% of the cases, with low morbidity and mortality and little increment in surgical timeinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.135 n.7 20072007-07-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000700007es10.4067/S0034-98872007000700007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Atrial fibrillation Cryosurgery Heart valves
spellingShingle	Atrial fibrillation Cryosurgery Heart valves Zalaquett S,Ricardo Pérez A,Erika Garayar P,Bernardita Vergara S,Ismael Moran V,Sergio Becker R,Pedro Irarrázaval Ll,Manuel J Ochoa T,Renato Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
description	Background: The Cox MAZE III operation for the treatment of atrial fibrillation (AF) is complex and consumes significant operative time. Cryoablation of the pulmonary veins (CPV) is a simpler alternative for patients that require concomitant valvular surgery. Aim: To evaluate CPV in patients with AF submitted to valvular surgery. Patients and Methods: Twenty one patients had simultaneous valvular surgery and CPV, 81 % of them had permanent AFfor an average of 5 years. Twenty patients had mitral valve disease. The etiology was rheumatic in 14. Average left atrial diameter was 60 mm. In 7patients the mitral valve was replaced, in 5 it was repaired, in 7 both mitral and aortic valve were replaced, in 1 the mitral valve was repaired and the aortic valve was replaced and in 1 only the aortic valve was replaced. A combined transeptal and superior approach was used for all patients. The CPV was performed after the valvular procedure with cryothermy at -60°C for 2 minutes with two 15 mm cryoprobes applied simultaneously. Results: CPV increased surgical time by 10 to 20 minutes. Operative mortality was 4.8% (1 patient). One patient developed a pericardial effusion and another a complete heart block that required a permanent pacemaker. All patients improved their functional class. At the end of an average 10.5 months of follow-up, 50% of patients were in normal sinus rhythm and 25% persisted in AF. The remaining patients were in some type of regular rhythm. Conclusions: CPV as a complementary procedure in patients with AF undergoing valvular surgery had good results to abate AF. It restored normal sinus rhythm in 50% of the cases, with low morbidity and mortality and little increment in surgical time
author	Zalaquett S,Ricardo Pérez A,Erika Garayar P,Bernardita Vergara S,Ismael Moran V,Sergio Becker R,Pedro Irarrázaval Ll,Manuel J Ochoa T,Renato
author_facet	Zalaquett S,Ricardo Pérez A,Erika Garayar P,Bernardita Vergara S,Ismael Moran V,Sergio Becker R,Pedro Irarrázaval Ll,Manuel J Ochoa T,Renato
author_sort	Zalaquett S,Ricardo
title	Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
title_short	Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
title_full	Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
title_fullStr	Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
title_full_unstemmed	Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
title_sort	criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular
publisher	Sociedad Médica de Santiago
publishDate	2007
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872007000700007
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Criocoagulación de venas pulmonares como tratamiento complementario de la fibrilación auricular en cirugía valvular

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