LEFT ATRIUM SURGICAL ISOLATION IN PATIENTS WITH ATRIAL FIBRILLATION, IHD AND MITRAL VALVE PATHOLOGY

Aim. To analyze the results of the left atrium isolation in the treatment of atrial fibrillation among patients with ischemic heart disease (IHD) and mitral valve (MV) pathology. Materials and methods. Case histories of 100 patients, operated during the period from January 2009 to December 2012 were analyzed retrospectively. All the patients underwent left atrium isolation procedure “left atrial maze” associated with mitral valve pathology correction. Results. Four patients died in the early postoperative period. The mean duration and completeness of case monitoring was 11,3 ± 2,5 months (from 0,5 to 15 months) and 93,75 %, respectively. Patients free from atrial fibrillation and acute cerebral circulation abnormalities during the first postoperative year made 75 % and 98,7 %, respectively. Taking into account the results of multiple-factor analysis, it was established that increase in the MV fibrous ring diameter (OR 1,47; p = 0,027; CI 1,04-2,08) and tricuspid insufficiency equal to 2+ and higher (OR 11; p = 0,038; CI 1,13-106,4) served as independent predictors of fibrillation relapse and atrial flutter within the postoperative months 6 and 12. Conclusions. According to the results of the early follow-up period, left atrium isolation “left atrial maze” in treatment of atrial fibrillation associated with mitral valve pathology correction is an effiective technique for sinus rhythm restoration, and its results are comparable with those of the other modifications of “maze” procedure.