“Can Heart Valve Replacement & Atrial Fibrillation Treatment Occur During The Same Surgery?” Asks Wendy

Wendy just sent me an interesting question about heart valve replacement surgery and atrial fibrillation. She writes, “Adam – At 68, I’m confused and nervous. I’ve been dealing with atrial fibrillation for some time. But, I was just diagnosed with a severely leaking mitral valve. Can a surgeon fix both problems during one operation? Or, will I need two separate procedures? Thanks, Wendy”

To answer Wendy’s question, I spoke with Dr. Niv Ad, chief of cardiothoracic surgery at Inova Heart & Vascular Institute in Falls Church, Virginia. Dr. Ad shared several helpful facts about atrial fibrillation and its connection to heart valve disease.

• According to Dr. Niv Ad, between 35%-50% of heart valve patients have some type of atrial fibrillation (abnormal heart rhythm) at the time of their surgery.
• Dr. Ad suggested that atrial fibrillation (A-Fib) is seen most commonly in patients with mitral valve disease but not infrequent in patients with aortic valve disease.
• Atrial fibrillation is more common in patients over 65 years of age, according to Dr. Ad.
• While A-Fib may not be directly related to valve disease, it is common that patients with atrial fibrillation can develop a dilated left ventricle that, in turn, results in significant mitral regurgitation.

Specific to Wendy’s question about the surgical treatment of heart valve disease and A-Fib during the same operation, Dr. Ad believes that approach is not only possible but appropriate.

“Your surgeon should have more than a good reason not to address atrial fibrillation during a valve procedure… Correcting A-Fib is going to improve surgical outcomes and the patient’s quality of life — without increasing the operative risk in the majority of cases.” — Dr. Niv Ad

Last year, I was fortunate to observe Dr. Niv Ad and Dr. Paul Massimiano perform a minimally invasive mitral valve repair and Maze procedure (for atrial fibrillation) during a 4-hour operation. Here’s a picture of Dr. Ad completing the Maze procedure with a cryoprobe.

Thanks to Wendy for her question about atrial fibrillation and heart valve replacement surgery. And, a special thanks to Dr. Niv Ad for sharing his clinical expertise. To learn more about heart valve replacements, click here.

Keep on tickin!