Frequency and Outcome of Postoperative Atrial Fibrillation Following Mitral Valve Replacement for Mitral Stenosis

To determine the frequency and outcome of postoperative atrial fibrillation (POAF) in terms of in-hospital and 30-day mortality and morbidity after mitral valve replacement (MVR). Observational study. Place and Duration of the Study: Department of Cardiac Surgery, Northwest General Hospital and Rese...

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Published in:	Journal of the College of Physicians and Surgeons--Pakistan Vol. 34; no. 10; pp. 1233 - 1237
Main Authors:	Khan, Kiramat Ullah, Iqbal, Tahir, Tariq, Arooba, Ali, Mubeen, Ali, Niaz
Format:	Journal Article
Language:	English
Published:	Pakistan College of Physicians and Surgeons Pakistan 01-10-2024
Subjects:	Adult Aged Atrial fibrillation Atrial Fibrillation - epidemiology Atrial Fibrillation - etiology Care and treatment Complications Complications and side effects Female Heart Valve Prosthesis Implantation - adverse effects Heart valve replacement Hospital Mortality Humans Male Methods Middle Aged Mitral Valve - surgery Mitral valve stenosis Mitral Valve Stenosis - surgery Pakistan - epidemiology Patient outcomes Postoperative Complications - epidemiology Risk Factors Statistics Surgery Treatment Outcome Young Adult Pakistan
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Summary:	To determine the frequency and outcome of postoperative atrial fibrillation (POAF) in terms of in-hospital and 30-day mortality and morbidity after mitral valve replacement (MVR). Observational study. Place and Duration of the Study: Department of Cardiac Surgery, Northwest General Hospital and Research Centre, Peshawar, Pakistan, from September 2017 to March 2023. A total of 186 patients between the ages of 20 and 70 years, who had severe mitral stenosis and normal sinus rhythm and underwent MVR surgery, were included in the study. The frequency of POAF within 7 days following surgery and outcomes in terms of in-hospital and 30-day mortality / morbidity were recorded. POAF occurred in 19.4% patients. Patients with POAF were predominantly male (p = 0.01), aged over 50 years (p = 0.002), diabetic (p = 0.02), hypertensive (p = 0.02), had impaired LV function (p <0.001), enlarged LA (p = 0.003), pulmonary hypertension (p = 0.009), previous PMBV (p <0.001), and previous infective endocarditis (p <0.001). In-hospital and 30-day mortality rates were 7% and 8.6%, respectively. POAF patients had prolonged ICU stays (p <0.001), hospital stays (p = 0.04), and higher mortality rates (p <0.001). Persistent AF (22%) contributed to 30-day morbidity in the form of embolic stroke, limb ischaemia, and congestive heart failure. POAF commonly occurs following the MVR surgery and significantly impacts perioperative and 30-day morbidity and mortality. Postoperative atrial fibrillation, Mitral stenosis, Mitral valve replacement.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1022-386X 1681-7168 1681-7168
DOI:	10.29271/jcpsp.2024.10.1233