Risks of Stroke and Bleeding After Heart Surgery for Atrial Fibrillation
Author Information
Author(s): Anders Albåge, Farkas Vanky, Gabriella Boano, Anders Holmgren, Lena Jidéus, Birgitta Johansson, Göran Kennebäck, Shahab Nozohoor, Henrik Scherstén, Johan Sjögren, Anders Wickbom, Torbjörn Ivert
Primary Institution: Uppsala University, Uppsala, Sweden
Hypothesis
What are the long-term risks of ischaemic stroke and cerebral bleeding in patients with atrial fibrillation after mitral valve surgery and concomitant Cox-maze IV procedure?
Conclusion
The study found that surgery for mitral valve insufficiency and concomitant Cox-maze IV has a low perioperative risk and a low long-term risk of stroke, which is associated with higher CHA2DS2-VASc scores.
Supporting Evidence
- The mean follow-up was 8.7 years, with survival without ischaemic stroke or cerebral haemorrhage at 5 and 10 years being 90% and 74%, respectively.
- Nineteen patients experienced ischaemic stroke during follow-up, with a linearized rate of 0.6% per patient-year.
- Patients with a history of stroke preoperatively had a higher risk of postoperative stroke.
Takeaway
Doctors did a heart surgery to help patients with a heart problem and found that most of them didn't have strokes afterward, but those who had strokes before were more likely to have them again.
Methodology
This was a retrospective nationwide analysis of 397 patients who underwent mitral valve surgery and Cox-maze IV procedure in Sweden from 2009 to 2017, followed until September 2022.
Potential Biases
The study's retrospective nature may introduce biases related to data collection and patient selection.
Limitations
The study did not have valid information about long-term rhythm results or late freedom from atrial fibrillation, and it lacked data on compliance with prescribed medications.
Participant Demographics
The cohort included 397 patients, with one-fourth being females and 71% having non-paroxysmal atrial fibrillation.
Statistical Information
Confidence Interval
95% confidence intervals for survival rates were calculated.
Digital Object Identifier (DOI)
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