THE IMMEDIATE RESULTS OF ATRIAL CRYOABLATION PROCEDURE IN COMBINATION WITH CORRECTION OF MITRAL VALVE PATHOLOGY

Komarov Roman Nikolaevich, Matsuganov Denis Alekseevich, Nuzhdin Mikhail Dmitrievich

Aim. To analyze the immediate and long-term results of the atrial cryoablation procedure in combination with the correction of mitral valve defect, to determine the predictors that increase the risk of recurrence of atrial fibrillation, as well as to determine the critical points of quantitative indicators that affect the increase in risk. Methods. During the period from January 2019 to December 2021, on the basis of the Department of Cardiac Surgery of the Chelyabinsk Regional Clinical Hospital, 45 patients, including 22 men, 23 women, with mitral valve pathology of various etiologies complicated by atrial fibrillation, underwent atrial cryoablation procedure using the «MAZEIV» technique, as well as surgical correction of mitral valve defect valves with/without correction of tricuspid valve defect. The diagnostic significance of quantitative signs in predicting a certain outcome was carried out using the ROC curve analysis method, survival analysis was carried out using the Cox regression method. Results. Freedom from atrial fibrillation within 2 years after surgery was 88.9%. A prognostic model describing freedom from atrial fibrillation depending on the impact of risk factors has been developed. Long–term persistent and permanent forms of atrial fibrillation are accompanied by an increase in the risk of recurrence of atrial fibrillation by 2.36 times, an increase in the size of the left atrium by 1 centimeter - an increase in the risk of recurrence of atrial fibrillation by 3.56 times, an increase in the left ventricle end–systolic diameter by 1 centimeter - an increase in the risk of recurrence of atrial fibrillation by 3.16 times. Conclusion. According to the results of our study, it was proved that the size of the left atrium is more than 5.45 cm, the left ventricle end–systolic diameter is more than 3.85 cm, as well as long-term persistent and permanent forms of atrial fibrillation were associated with a high risk of recurrence. This prognostic model will allow a more thorough approach to the selection of patients for the procedure of atrial cryoablation.

Keywords:mitral valve, atrial cryoablation, AF reccurence