Document Detail


Intermediate-term outcomes of surgical atrial fibrillation correction with the CryoMaze procedure.
MedLine Citation:
PMID:  19379884     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Few studies have reported long-term outcomes of surgical atrial fibrillation (AF) correction. We perform the Cox-Maze III lesion set with argon-powered cryoenergy (CryoMaze procedure) on all patients with AF presenting for cardiac operations. This study reports long-term clinical results and heart rhythm status. METHODS: Between July 2002 and November 2005, 119 consecutive patients underwent surgical AF correction with the CryoMaze procedure. Mitral valve disease was the primary indication for operation in 66%. AF was continuous in 65%. Rhythm assessment was with 2-week continuous electrocardiographic (ECG) monitoring in 75% of patients and by noncontinuous ECG in the remainder. Median follow-up was 3.2 years and was 98% complete. RESULTS: There was one hospital (0.8%) death. Survival at 3 years was 84%. One perioperative stroke resolved completely. No late strokes occurred. In 4 of 119 patients (4 (3.4%), pacemakers were inserted during the index hospitalization. Median length of stay was 7 days. Overall freedom from AF more than 3 years after operation was 60%. Among patients with preoperative intermittent AF, 85% (28 of 33) were in normal sinus rhythm, and 47% (27 of 58) with continuous AF were in normal sinus rhythm (p < 0.001). CONCLUSIONS: CryoMaze AF correction is safe and is associated with a very low risk of stroke. Rates of normal sinus rhythm at more than 3 years postoperatively were high for patients with intermittent AF and acceptable for those with continuous AF. This experience supports wider application of the CryoMaze to all patients with AF who need cardiac operations.
Authors:
James S Gammie; Parijat Didolkar; Leandra S Krowsoski; Mary J Santos; Ann J Toran; Cindi A Young; Bartley P Griffith; Stephen R Shorofsky; Thomas J Vander Salm
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Annals of thoracic surgery     Volume:  87     ISSN:  1552-6259     ISO Abbreviation:  Ann. Thorac. Surg.     Publication Date:  2009 May 
Date Detail:
Created Date:  2009-04-21     Completed Date:  2009-05-14     Revised Date:  2010-01-28    
Medline Journal Info:
Nlm Unique ID:  15030100R     Medline TA:  Ann Thorac Surg     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1452-8; discussion 1458-9     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiac Surgery, University of Maryland Medical Center, Baltimore, Maryland 21201, USA. jgammie@smail.umaryland.edu
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Atrial Fibrillation / etiology,  mortality,  surgery*
Cardiac Surgical Procedures / methods
Catheter Ablation / methods
Electrocardiography / methods
Female
Heart Rate
Heart Valve Diseases / mortality,  physiopathology,  surgery*
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation / methods,  mortality
Humans
Interviews as Topic
Length of Stay
Male
Middle Aged
Mitral Valve Stenosis / complications,  surgery*
Pacemaker, Artificial
Retrospective Studies
Stroke / surgery
Survival Rate
Survivors
Treatment Outcome
Young Adult
Comments/Corrections
Comment In:
Ann Thorac Surg. 2010 Jan;89(1):340-1   [PMID:  20103281 ]

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


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