TY - JOUR AU - Gocer, Hakan AU - Durukan, Ahmet Baris AU - Unlu, Ahmet AU - Unal, Mustafa PY - 2020/03/11 Y2 - 2024/03/29 TI - Comparison of P-Wave Duration and Dispersion in Mitral Valve Replacement Surgery Via Right Atrial Transseptal or Left Atrial Approach in Rheumatic Mitral Stenosis Patients JF - The Heart Surgery Forum JA - HSF VL - 23 IS - 2 SE - DO - 10.1532/hsf.2667 UR - https://journal.hsforum.com/index.php/HSF/article/view/2667 SP - E118-E122 AB - <p class="p1"><span class="s1"><strong>Background:</strong> Predisposition to atrial fibrillation in mitral valve surgery has been well demonstrated. The changes in electrocardiographic parameters (P<sub>max</sub>, P<sub>min</sub> and P-wave dispersion) related to AF risk are unknown. We aimed to document the relationship between electrocardiographic changes and mitral valve replacement through right or left atrial surgical approaches.</span></p><p class="p1"><span class="s1"><strong>Methods:</strong> We retrospectively studied 154 patients, who underwent mitral valve replacement surgery from 2008 to 2018. Seventy-nine patients were operated with right atriotomy and transseptal approach (Group 1), and 75 patents were operated with left atriotomy (Group 2). ECGs obtained at hospital admittance and postoperatively at 24 hours were blindly analyzed.</span></p><p class="p1"><span class="s1"><strong>Results:</strong> Preoperative demographic characteristics were similar. P<sub>max</sub>, P<sub>min</sub> and P-wave dispersion were similar preoperatively. All parameters increased in both groups compared with the preoperative values (<em>P</em> &lt; .05). Postoperative P<sub>max</sub>, P<sub>min</sub> and P-wave dispersion all were statistically significantly higher with the right atrial approach (<em>P</em> &lt; .05). Postoperative AF also was more common in Group 1 (<em>P</em> &lt; .05).</span></p><p class="p1"><span class="s1"><strong>Conclusion:</strong> Right atrial approach may lead to higher P-wave changes and atrial arrhythmias. This may be due to more extensive surgical disruption. The changes in atrial anatomic structure can increase atrial arrhythmic propensity and can cause atrial fibrillation.</span></p> ER -