ArticleJournal of the American Heart Association2025
Surgical Strategy for Atrial Functional Mitral Regurgitation With Atrial Fibrillation.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Atrial Secondary Mitral Regurgitation: Pathophysiology, Diagnosis, and Surgical Implications.Medicina (Kaunas, Lithuania) · 2026Review
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtrial functional mitral regurgitation (AFMR) combined with atrial fibrillation (AF) has become a significant clinical challenge. This study evaluates surgical treatment strategies based on the degree of MR and rhythm control therapy for patients with AFMR and AF.
methodsThis retrospective study included 145 patients with AF and MR from January 2017 to January 2023. Patients were grouped as follows: moderate atrial regurgitation (n=33), severe atrial regurgitation (SAR, n=56), and severe primary regurgitation (SPR, n=56). The group with moderate atrial regurgitation underwent thoracoscopic AF procedure with a unilateral approach, and the SAR and SPR groups received mitral valvuloplasty plus the Cox-Maze IV procedure. Descriptive characteristics and treatment outcomes were analyzed.
resultsAt an average follow-up of 2.6±1.1 years, 23 patients in the group with moderate atrial regurgitation maintained sinus rhythm. MR improved in 26 patients, remained unchanged in 6 patients, and worsened in 1 patient. Sinus rhythm maintenance was associated with MR reduction (
conclusionsRhythm control therapy is essential for treating AFMR with AF. The thoracoscopic AF procedure is effective and minimally invasive for moderate AFMR. For severe AFMR, Cox-Maze IV combined with mitral valvuloplasty provides optimal safety and effectiveness.
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