Mini-Maze Suffices as Adjunct to Mitral Valve Surgery in Patients with Preoperative Atrial Fibrillation
| Autor: | EG Pieper, JG Grandjean, Rcg Huet, Robert G. Tieleman, Hjgm Crijns, van Isabelle Gelder, Jmaa Van der Maaten, Msct Ebels, PJ de Kam, AE Tuinenburg |
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| Rok vydání: | 2000 |
| Předmět: |
Male
medicine.medical_specialty Cox maze procedure medicine.medical_treatment Electric Countershock Heart Valve Diseases Cardioversion Pharmacotherapy Physiology (medical) Mitral valve Internal medicine Atrial Fibrillation Heart rate medicine Humans Sinus rhythm Cardiac Surgical Procedures Aged Retrospective Studies business.industry Atrial fibrillation Middle Aged medicine.disease Surgery Cardiac surgery Treatment Outcome medicine.anatomical_structure Echocardiography Cardiology Mitral Valve Female Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | Journal of Cardiovascular Electrophysiology. 11:960-967 |
| ISSN: | 1540-8167 1045-3873 |
| Popis: | Mini-Maze and Mitral Valve Surgery. Introduction: After mitral valve (MV) surgery, preoperative atrial fibrillation (AF) often recurs while cardioversion therapy generally fails. Additional Cox maze surgery improves postoperative arrhythmia outcome, but the extensive nature of such an approach limits general appliance. We investigated the clinical outcome of a simplified, less extensive Cox maze procedure ("mini-maze") as adjunct to MV surgery. Methods and Results: Thirteen patients with MV disease and preoperative AF were treated with combined surgery (group 1). Nine control patients without previous AF underwent isolated MV surgery (group 2), We retrospectively compared the results to findings in 23 patients with preoperative AF who had undergone isolated MV surgery (group 3), In group 1, mini-maze took an additional 46 minutes of perfusion time. One 75-year-old patient died of postoperative multiple organ failure. Seven patients showed spontaneously converting (within 2 months) postoperative AF. After 1 year, 82% were in sinus rhythm (SR), No sinus node dysfunction was observed, In group 2, all patients were in SR after 1 year, In group 3, only 53% were in SR after 1 year, despite serial cardioversion and antiarrhythmic drug therapy. Exercise tolerance and heart rate were comparable for groups 1 and 2, Left atrial function was present in all but one patient in group 1 and in all patients in group 2 (after MV reconstruction). Conclusion: Adding a relatively simple mini-maze to MV surgery improves arrhythmia outcome in patients with preoperative AF without introducing sinus node dysfunction or persistent absence of left atrial function. The results of this type of combined surgery are encouraging and deserve further attention. |
| Databáze: | OpenAIRE |
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