Abstract
Background: We hypothesized that the post-operative aorto-mitral angle
might relate to the occurrence of post-operative atrial arrhythmia (AA),
including atrial fibrillation and atrial tachycardia, after mitral valve
repair in patients with mitral regurgitation (MR). The purpose of the
present study was to determine the effects of the post-operative
aorto-mitral angle on new onset AA after mitral valve repair with mitral
annuloplasty for treating MR.
Methods: One-hundred seventy-two patients without any history of AA
underwent mitral valve repair with mitral annuloplasty in our
institution between 2008 and 2017. Patient information, including
medical records and echocardiographic data, were retrospectively
studied.
Results: AA occurred in 15 (8.7%) patients during the follow-up period
(median, 35.7 months; range, 0.5-132 months). The patients with AA had a
longer cardiopulmonary bypass time and a smaller aorto-mitral angle at
post-operative TTE than the others (119 ± 6 degrees vs. 125 ± 10
degrees, P = 0.003). There was no significant difference in the degree
of post-operative residual MR or functional MS between the groups. In a
multivariate Cox proportional hazards analysis, the longer
cardiopulmonary bypass time and the smaller post-operative aorto-mitral
angle were independent predictors of the occurrence of AA during the
follow-up period (odds ratio per 10 minutes 1.11; 95% CI 1.02-1.22, P =
0.019: odds ratio 0.91; 95% CI 0.85-0.98, P = 0.012).
Conclusion: A small aorto-mitral angle at post-operative TTE was a
predictor of new onset AA after a mitral valve repair for treating MR.