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Exclusion versus preservation of the left atrial appendage in rheumatic mitral valve surgery
DC Field | Value | Language |
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dc.contributor.author | 김완기 | - |
dc.date.accessioned | 2021-05-21T17:09:39Z | - |
dc.date.available | 2021-05-21T17:09:39Z | - |
dc.date.issued | 2020-12 | - |
dc.identifier.issn | 1355-6037 | - |
dc.identifier.uri | https://ir.ymlib.yonsei.ac.kr/handle/22282913/182736 | - |
dc.description.abstract | Objectives: This study aimed to evaluate the impact of left atrial appendage exclusion on clinical outcomes in patients with atrial fibrillation (AF) undergoing rheumatic mitral surgery. Methods: We retrospectively reviewed 1226 consecutive patients with AF (54.5±11.6 years; 68.2% females) who underwent rheumatic mitral valve (MV) surgery from 1997 to 2016. The left atrial appendage was preserved in 836 (68.2%) and excluded in 390 (31.8%) patients. Surgical AF ablation was performed in 506 (60.5%) and 304 (77.9%) patients with preserved and excluded left atrial appendage, respectively. For baseline adjustment, propensity matching was used. Results: During a median follow-up of 63.4 months (IQRs, 20-111 months), there were no significant intergroup differences in the risks of mortality (2.77% vs 3.03%/patient-years) and thromboembolic events (0.91% vs 1.02%/patient-years). In the 258 pairs of propensity-score matched patients, death (2.77% vs 3.03%/patient-years) and thromboembolism (1.36% vs 0.82%/patient-years) outcomes were comparable for both groups. In a subgroup undergoing ablation (n=810), there were no significant differences in the adjusted risks of death (HR, 0.67; 95% CI, 0.34 to 1.32) and thromboembolism (HR, 0.47; 95% CI, 0.18 to 1.26). In a subgroup not undergoing ablation (n=416), however, left atrial appendage preservation tended to have higher adjusted risks for death (HR, 2.24; 95% CI, 0.98 to 5.13) and thromboembolism (HR, 4.41; 95% CI, 0.97 to 20.1). Conclusions: Left atrial appendage preservation did not seem to have greater risks of adverse clinical events in patients with AF undergoing rheumatic MV surgery particularly when ablation procedure is combined. | - |
dc.description.statementOfResponsibility | restriction | - |
dc.language | English | - |
dc.publisher | BMJ Pub. Group. | - |
dc.relation.isPartOf | HEART | - |
dc.rights | CC BY-NC-ND 2.0 KR | - |
dc.title | Exclusion versus preservation of the left atrial appendage in rheumatic mitral valve surgery | - |
dc.type | Article | - |
dc.contributor.college | College of Medicine (의과대학) | - |
dc.contributor.department | Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) | - |
dc.contributor.googleauthor | Wan Kee Kim | - |
dc.contributor.googleauthor | Ho Jin Kim | - |
dc.contributor.googleauthor | Joon Bum Kim | - |
dc.contributor.googleauthor | Sung Ho Jung | - |
dc.contributor.googleauthor | Suk Jung Choo | - |
dc.contributor.googleauthor | Cheol Hyun Chung | - |
dc.contributor.googleauthor | Jae Won Lee | - |
dc.identifier.doi | 10.1136/heartjnl-2019-316387 | - |
dc.contributor.localId | A06065 | - |
dc.relation.journalcode | J00976 | - |
dc.identifier.eissn | 1468-201X | - |
dc.identifier.pmid | 32376607 | - |
dc.identifier.url | https://heart.bmj.com/content/106/23/1839.long | - |
dc.subject.keyword | atrial arrhythmia ablation procedures | - |
dc.subject.keyword | atrial fibrillation | - |
dc.subject.keyword | mitral stenosis | - |
dc.subject.keyword | stroke | - |
dc.contributor.alternativeName | Kim, Wan Kee | - |
dc.contributor.affiliatedAuthor | 김완기 | - |
dc.citation.volume | 106 | - |
dc.citation.number | 23 | - |
dc.citation.startPage | 1839 | - |
dc.citation.endPage | 1846 | - |
dc.identifier.bibliographicCitation | HEART, Vol.106(23) : 1839-1846, 2020-12 | - |
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