SciELO - Scientific Electronic Library Online

 
vol.135 número7Análisis de la opinión de usuarios sobre calidad percibida y satisfacción con hospitales públicos: Estudio de caso desde la perspectiva de la aplicación del marketingDeterminación de los índices glicémicos y de insulina en fórmulas para alimentación enteral en adultos sanos índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Articulo

Indicadores

Links relacionados

Compartir


Revista médica de Chile

versión impresa ISSN 0034-9887

Resumen

ZALAQUETT S, Ricardo et al. Cryoablation of pulmonary veins as complementary treatment of atria I fibrillation in valvular surgery. Rev. méd. Chile [online]. 2007, vol.135, n.7, pp. 871-878. ISSN 0034-9887.  http://dx.doi.org/10.4067/S0034-98872007000700007.

Background: The Cox MAZE III operation for the treatment of atrial fibrillation (AF) is complex and consumes significant operative time. Cryoablation of the pulmonary veins (CPV) is a simpler alternative for patients that require concomitant valvular surgery. Aim: To evaluate CPV in patients with AF submitted to valvular surgery. Patients and Methods: Twenty one patients had simultaneous valvular surgery and CPV, 81 % of them had permanent AFfor an average of 5 years. Twenty patients had mitral valve disease. The etiology was rheumatic in 14. Average left atrial diameter was 60 mm. In 7patients the mitral valve was replaced, in 5 it was repaired, in 7 both mitral and aortic valve were replaced, in 1 the mitral valve was repaired and the aortic valve was replaced and in 1 only the aortic valve was replaced. A combined transeptal and superior approach was used for all patients. The CPV was performed after the valvular procedure with cryothermy at -60°C for 2 minutes with two 15 mm cryoprobes applied simultaneously. Results: CPV increased surgical time by 10 to 20 minutes. Operative mortality was 4.8% (1 patient). One patient developed a pericardial effusion and another a complete heart block that required a permanent pacemaker. All patients improved their functional class. At the end of an average 10.5 months of follow-up, 50% of patients were in normal sinus rhythm and 25% persisted in AF. The remaining patients were in some type of regular rhythm. Conclusions: CPV as a complementary procedure in patients with AF undergoing valvular surgery had good results to abate AF. It restored normal sinus rhythm in 50% of the cases, with low morbidity and mortality and little increment in surgical time

Palabras clave : Atrial fibrillation; Cryosurgery; Heart valves.

        · texto en Español     · pdf en Español