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Post-operative left atrial volume index is a predictor of the occurrence of permanent atrial fibrillation after mitral valve surgery in patients who undergo mitral valve surgery

 Min-Kyung Kang  ;  Boyoung Joung  ;  Chi Young Shim  ;  In Jeong Cho  ;  Woo-In Yang  ;  Jeonggeun Moon  ;  Yangsoo Jang  ;  Namsik Chung  ;  Byung-Chul Chang  ;  Jong-Won Ha 
 Cardiovascular Ultrasound, Vol.16(1) : 5, 2018 
Journal Title
 Cardiovascular Ultrasound 
Issue Date
Atrial fibrillation ; Left atrium ; Mitral valve
BACKGROUND: Atrial fibrillation (AF) can occur even after the correction of mitral valve (MV) pathology in patients who have pre-operative sinus rhythm and undergo MV surgery. However, the factors associated with the occurrence of AF after MV surgery are still unclear. The aim of this retrospective study was to investigate the factors determining the occurrence of permanent AF after MV surgery in patients with preoperative sinus rhythm who underwent MV surgery. METHODS: Four hundred and forty-two patients (mean age 46 +/- 12, 190 men) who underwent MV surgery and sinus rhythm were investigated retrospectively. Transthoracic echocardiography was performed before and after MV surgery at the time of dismissal. RESULTS: Permanent post-operative AF occurred in 81 (18%) patients even after successful MV surgery and preoperative sinus rhythm. It was more common in rheumatic etiology, a presence of mitral stenosis, lower pre- and post-operative left ventricular ejection fraction, higher post-operative mean diastolic pressure gradient across mitral prosthesis, larger post-operative left atrial volume index (LAVI) and lesser degrees of reduction in LAVI after surgery. In multiple regression analysis, post-operative LAVI was found to be an independent predictor for occurrence of AF. Post-operative LAVI > 39 ml/m2 was the cut-off value for best prediction of new onset permanent AF (sensitivity: 79%, AUC: 0.762, SE: 0.051, p < 0.001). CONCLUSION: New-onset permanent post-operative AF is not uncommon, even after successful MV surgery despite pre-operative sinus rhythm. Larger post-operative LAVI was an independent predictor for the occurrence of AF.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Chang, Byung Chul(장병철)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Cho, In Jeong(조인정)
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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