Study population
Between July 2008 and July 2018, 2,628 consecutive patients underwent
first-time, elective isolated surgical AVR using a mechanical or stented
biological valve prosthesis. Patients with concomitant cardiac
surgeries, previous cardiac surgery, urgent/emergency surgeries, or
transthoracic echocardiography showing other significant valve
abnormalities apart from those concerning the aortic valve were
excluded. Preoperative AF was documented on a 12-lead electrocardiogram
and/or Holter recording within the 3 months prior to surgery. There was
no distinction made between preoperative paroxysmal or persistent AF.
Data on the duration of AF diagnosis were not available. The AVR was
performed according to standard of care and in line with local
protocols. In addition to patient’s preference, the cut-off age for
using mechanical versus biological prosthesis was dictated according to
updated practice guidelines.