Background: Atrial fibrillation (AF) is the most common arrhythmia. Compared to AF patients without mitral valve disease, the risk of thrombo-embolism and stroke is increased among AF patients with mitral valve disease. This study aimed to evaluate the effect of concomitant surgical closure of left atrial appendage (LAA) during mitral valve replacement in AF patients on the incidence of embolic stroke and analysis of possible intra- and post-operative risks. Methods: This prospective study included 60 AF patients who underwent mitral valve replacement. Patients were divided into two equal groups: Group A underwent mitral valve replacement without surgical closure of LAA and group B underwent mitral valve replacement with concomitant surgical closure of LAA. Results: The only predictor for TIA was type of surgery done. Being group B was associated with 60.0% reduction in risk of occurrence of TIA among studied patients (P=0.014). The only predictor for occurrence of stroke was age of participants. One year increase in age was associated with 1.12time increase risk of occurrence of stroke among studied patients (P=0.028). The only predictor for post-operative complications was type of surgery done. Being group B was associated with 0.29 times reduction in risk of occurrence of TIA among studied patients (P=0.04). Conclusion: Concomitant LAA closure during MVR in AF patients did not significantly reduce the incidence of stroke in this study but was associated with reduction in TIA, although it was associated with a reduction in cross-clamp time and a trend towards fewer TIA events in the multivariate analysis. |
