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Atrial fibrillation (AF) has been recently proven
to be an independent risk factor for mortality in general population1.
Similarly, after mitral valve surgery, AF is related to poorer survival rates with respect to sinus rhythm
(SR)2.
Many different reasons caused in the last few years a growing interest for
combined surgical treatment of the arrhythmia during open heart operations. The
prevalence of AF in patients scheduled for a mitral valve procedure is still between
30 and 84%3-5. When AF is persistent, the of SR recovery after a conventional heart
operation alone ranges from 4.5 to 36% and it is even lower in patients with left
atriomegaly1. In the era of conservative valve surgery, cure of AF allows avoiding
chronic treatment with oral anticoagulants in all patients undergoing mitral valve repair
or replacement with a bioprosthesis. Moreover even in patients on anticoagulant
medications after mitral valve replacement with a mechanical prosthesis, intracavitary
thrombosis and prethrombotic phenomena are favoured by AF6.
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