PDF(Pubmed)
Abstract：
BACKGROUND: Atrial functional mitral regurgitation (AFMR) is a newly discovered condition associated with longstanding atrial fibrillation. This retrospective study aimed to analyze the outcomes of the maze procedure and mitral regurgitation (MR) surgery in AFMR and atrial fibrillation in comparison with those in degenerative MR (DMR).
METHODS: Patients who underwent mitral valve repair/replacement with a maze procedure at a hospital (July 2012-August 2021) were included. We excluded patients aged below 18 years undergoing concomitant coronary artery bypass grafting or atrial septal defect repair and those with MR etiology other than ARMR or DMR.
RESULTS: We included 35 patients with AFMR and 50 patients with DMR. Patient characteristics and postoperative outcomes were not significantly different between the two groups. Long-term outcomes revealed no significant differences in the ratio of cardiac mortality, stroke, or hospital readmission. However, after the maze procedure, the sinus rhythm restoration rate was significantly lower (62% vs. 28.5%, p < 0.001), a junctional rhythm state (p < 0.001) and permanent pacemaker insertion for sick sinus syndrome (SSS) (p = 0.03) were significantly more common in AFMR than DMR. On postoperative transthoracic echocardiography (TTE), the pulmonary artery systolic pressure was significantly less decreased in the AFMR group than in the DMR group compared with that on preoperative TTE (p = 0.04).
CONCLUSIONS: AFMR showed excellent mitral valve surgery outcomes, similar to DMR, but had a significantly higher risk of pacemaker insertion for SSS after the maze procedure.
METHODS: Patients who underwent mitral valve repair/replacement with a maze procedure at a hospital (July 2012-August 2021) were included. We excluded patients aged below 18 years undergoing concomitant coronary artery bypass grafting or atrial septal defect repair and those with MR etiology other than ARMR or DMR.
RESULTS: We included 35 patients with AFMR and 50 patients with DMR. Patient characteristics and postoperative outcomes were not significantly different between the two groups. Long-term outcomes revealed no significant differences in the ratio of cardiac mortality, stroke, or hospital readmission. However, after the maze procedure, the sinus rhythm restoration rate was significantly lower (62% vs. 28.5%, p < 0.001), a junctional rhythm state (p < 0.001) and permanent pacemaker insertion for sick sinus syndrome (SSS) (p = 0.03) were significantly more common in AFMR than DMR. On postoperative transthoracic echocardiography (TTE), the pulmonary artery systolic pressure was significantly less decreased in the AFMR group than in the DMR group compared with that on preoperative TTE (p = 0.04).
CONCLUSIONS: AFMR showed excellent mitral valve surgery outcomes, similar to DMR, but had a significantly higher risk of pacemaker insertion for SSS after the maze procedure.
摘要：
背景：心房功能性二尖瓣反流（AFMR）是一种新发现的与长期心房颤动相关的疾病。这项回顾性研究旨在分析AFMR和房颤的迷宫手术和二尖瓣反流（MR）手术与退行性MR（DMR）手术的结果。
方法：纳入了在医院（2012年7月至2021年8月）进行迷宫手术的二尖瓣修复/置换患者。我们排除了年龄在18岁以下同时接受冠状动脉旁路移植术或房间隔缺损修复术的患者以及除ARMR或DMR以外的MR病因患者。
结果：我们纳入了35例AFMR患者和50例DMR患者。两组患者特征和术后结局无明显差异。长期结果显示心脏死亡率的比率没有显着差异，中风,或者再入院.然而,迷宫程序后，窦性心律恢复率显着降低（62%vs.28.5%,p<0.001)，与DMR相比,AFMR患者出现交界性节律状态(p<0.001)和永久性起搏器置入病态窦房结综合征(SSS)(p=0.03)更为常见.术后经胸超声心动图（TTE），与术前TTE相比,AFMR组的肺动脉收缩压下降幅度明显低于DMR组(p=0.04).
结论：AFMR显示出优异的二尖瓣手术结果，类似于DMR,但是迷宫手术后插入SSS起搏器的风险明显更高。
方法：纳入了在医院（2012年7月至2021年8月）进行迷宫手术的二尖瓣修复/置换患者。我们排除了年龄在18岁以下同时接受冠状动脉旁路移植术或房间隔缺损修复术的患者以及除ARMR或DMR以外的MR病因患者。
结果：我们纳入了35例AFMR患者和50例DMR患者。两组患者特征和术后结局无明显差异。长期结果显示心脏死亡率的比率没有显着差异，中风,或者再入院.然而,迷宫程序后，窦性心律恢复率显着降低（62%vs.28.5%,p<0.001)，与DMR相比,AFMR患者出现交界性节律状态(p<0.001)和永久性起搏器置入病态窦房结综合征(SSS)(p=0.03)更为常见.术后经胸超声心动图（TTE），与术前TTE相比,AFMR组的肺动脉收缩压下降幅度明显低于DMR组(p=0.04).
结论：AFMR显示出优异的二尖瓣手术结果，类似于DMR,但是迷宫手术后插入SSS起搏器的风险明显更高。
