Mitral valve replacement impairs the flow in the left atrial appendage in mitral regurgitation

Abstract

Objective — We aimed to assess the left atrial appendage (LAA) flow velocities of rheumatic valves in 46 patients, diagnosed with isolated mitral regurgitation (MR) (16 patients), mitral stenosis (MS) (14 patients) and combined MS and MR (MS + MR) (16 patients) before and after operation.Methods — The patients were subdivided into two groups, according to rhythm: sinus (SR) (20 patients) and atrial fibrillation (AF) (26 patients).All patients underwent transthoracic and transoesophageal echocardiography before and after the operation.Results — Preoperatively LAA flow velocities were the best in the MR group among the three groups. Postoperatively there was no statistically significant difference between the MR group and the other two groups for mean peak emptying and filling velocities in patients with SR and AF.The incidence of spontaneous echo contrast (SEC) and thrombus significantly increased in the MR group after operation.Thrombus was only seen in patients with AF at the postoperative period.Conclusions — Mitral valve replacement disturbs LAA flow velocities and increases the risk of thrombus formation in patients with MR.This risk was more obvious in cases with AF. Impaired left atrial appendage flow velocities increase the risk of thrombus formation.We recommend close follow-up for the increased possibility of thrombus formation in patients who had MR preoperatively and AF postoperatively.