Современная стратегия хирургического лечения фибрилляции предсердий ассоциированной с клапанной патологией и ишемической болезнью сердца

Introduction. Among patients with valvular heart disease and coronary artery disease requiring surgical treatment of AF occurs in 30-84% of cases of presence of any form of AF in patients with valvular and ischemic heart disease worsens the prognosis of postoperative survival, increases the risk of fatal complications and worsens the quality of life. Purpose of the study. Optimize the indications for surgical treatment and prevention of atrial fibrillation with simultaneous correction of valve and coronary revascularization. Material and methods. 138 patients were operated on with simultaneous correction of valve and coronary artery bypass grafting. Of these, 100 male (73%) and 38 women (27%), aged 38 to 73 years (mean age 59 years). In this group, 14 patients had concomitant atrial fibrillation. Results. In the subgroup with paroxysmal AF, noted the restoration of sinus rhythm (SR) in patients preventively administered amiodarone (Cordarone), as well as after RFA mouths of the pulmonary veins. Conclusions. When you select a volume of surgical intervention in patients with heart valve defects, in conjunction with coronary lesion and concomitant AF, should be guided by the principle of minimal invasiveness. Prophylactic amiodarone (Cordarone) in the preand postoperative periods contributes both to the restoration and maintenance of sinus rhythm in patients with paroxysmal and persistent AF. All patients with comorbidity and concomitant AF should be the prevention of thromboembolic complications.