Surgical Treatment of Patients with Aortic Valve Disease in Association with Atrial Fibrillation

Abstract

The frequency of atrial fibrillation development in patients with severe aortic valve stenosis ranges from 4 to 30%. This arrhythmia significantly worsens patients’ long-term survival. Currently, it is considered that performing ablation of arrhythmogenic myocardial areas during valve surgery does not impact in-hospital mortality and does not lead to prolonged hospital stay. According to modern recommendations, this procedure should be performed in all patients diagnosed with atrial fibrillation if the pericardium is opened. There are numerous ablation protocols available. For patients with isolated aortic valve disease, there is no need to open the atria during ablation. For the majority of patients with persistent atrial fibrillation, isolating the posterior wall of the left atrium, including the pulmonary vein areas, is sufficient. This article proposes an original approach to the combined treatment of valve disease and arrhythmia using the Perceval-S sutureless valve and the Gemini-S clamp-ablator. This approach reduces the time of cardiopulmonary bypass, which can benefit high-risk surgical patients.