Experience of heart valve replacement combine with coronary artery bypass grafting surgical treatment

  AIM  To summarize the clinical effects of cardiac valvular surgery, coronary bypass surgery and bipolar atrial fibrillation radiofrequency ablation for patients with valvular heart disease, coronary heart disease and atrial fibrillation.

  METHODS  The clinical data of 188 patients with heart valvular disease, coronary heart disease combined with atrial fibrillation were selected. the patients and their families voluntarily chose whether or not to perform atrial fibrillation radiofrequency ablation at the same time. They were divided into the concurrent ablation group (n=96) and the non-ablation group (n=92). At the same time, patients in the concurrent ablation group underwent valvular surgery, coronary artery bypass grafting and radiofrequency ablation of bipolar atrial fibrillation, while patients in the non-ablation group underwent valvular surgery and coronary artery bypass grafting only. By comparing the time of cardiopulmonary bypass, the time of aortic occlusion, the time of ventilator intubation, the ICU monitoring time in the heart surgery and the time of hospitalization in the ordinary ward after the operation, the follow-up was 12 months after discharge. According to the follow-up results, the rate of sinus rhythm and cardiac function were recorded in 6 months and 12 months after the operation, the incidence of major cardiovascular adverse events (MACCE, including malignant arrhythmias, congestive heart failure, cerebral vascular embolism) within 12 months was recorded, and evaluated its clinical efficacy.

  RESULTS  The time of extracorporeal circulation and aorta interruption time: P<0.05, the difference between the two groups was statistically significant;there was no significant difference between the two groups in Ventilator intubation time, ICU monitoring time of cardiac surgery and hospitalization time of general ward after operation;the rate of sinus rhythm conversion in 6 months and 12 months after the operation: the concurrent ablation group was better than the non-ablation group (P<0.05); the cardiac function index (left atrium diameter, NT-proBNP, left ventricular ejection fraction) in 6 months and 12 months after operation: the concurrent ablation group was better than the non-ablation group (P<0.05), The incidence of MACCE in the concurrent ablation group was significantly lower than that in the non-ablation group in 12 months (P<0.05).

  CONCLUSION  For patients suffering from valvular heart disease, coronary heart disease and atrial fibrillation, the rate of sinus rhythm is higher and the clinical effect is better by coronary bypass surgery, valve surgery and bipolar atrial fibrillation radiofrequency ablation.