Document Detail


Cox maze procedure for chronic atrial fibrillation associated with mitral valve disease.
MedLine Citation:
PMID:  7983874     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Between April 1992 and October 1993, we combined a modified maze procedure with mitral valve repair (n = 26) or replacement (n = 36) in 62 patients with atrial fibrillation, including 16 patients undergoing reoperation. Associated procedures included aortic valve operation (n = 22), tricuspid annuloplasty (n = 28), atrial plication (n = 10), and others (n = 3). Duration of atrial fibrillation varied from 0.1 to 23 years (average 8.3 +/- 6.4 years), the f-wave voltage ranged from 0 to 0.45 mV (0.16 +/- 0.09 mV), and cardiothoracic ratio varied from 46% to 85% (64% +/- 9%). We modified the maze atriotomies to preserve the sinus node artery and used cryoablation to simplify procedures. Aortic crossclamp time was 142 +/- 25 minutes and cardiopulmonary bypass time 226 +/- 34 minutes. No early or late deaths occurred in a total of 783 patient-months of follow-up. In 52 patients (84%) who regained atrial rhythm, an atrial A-wave was detected in 84% for transtricuspid flow and in 71% for transmitral flow. One patient with sinus rhythm had an episode of transient neurologic ischemia 4 months after mechanical valve implantation. The 10 patients who remained in atrial fibrillation had preoperative fibrillation for a significantly longer time than the rest of the patients with atrial rhythm (14.8 versus 7.2 years p < 0.001) and a larger left atrial dimension (70 versus 58 mm, p < 0.01). Nonetheless, no variable alone could have predicted postoperative rhythm for individual patients. The results suggest that the maze procedure is safe and effective and therefore should be considered for patients with chronic atrial fibrillation undergoing mitral valve operations.
Authors:
Y Kosakai; A T Kawaguchi; F Isobe; Y Sasako; K Nakano; K Eishi; N Tanaka; Y Kito; Y Kawashima
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  108     ISSN:  0022-5223     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  1994 Dec 
Date Detail:
Created Date:  1995-01-03     Completed Date:  1995-01-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1049-54; discussion 1054-5     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Atrial Fibrillation / mortality,  surgery*
Cardiac Surgical Procedures / methods,  statistics & numerical data
Cardiopulmonary Bypass
Chronic Disease
Female
Follow-Up Studies
Heart Valve Diseases / mortality,  surgery
Humans
Male
Middle Aged
Mitral Valve* / surgery
Postoperative Complications / epidemiology
Reoperation / statistics & numerical data
Rheumatic Heart Disease / mortality,  surgery

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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