| Long-term follow-up of atrial contraction after the maze procedure in patients with mitral valve disease. | |
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MedLine Citation:
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PMID: 11345375 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We sought to determine the effectiveness of the maze procedure for maintaining sinus rhythm and atrial contraction for a long period in patients with mitral valve disease. BACKGROUND: Although the maze procedure for atrial fibrillation (AF) has been effective in restoring sinus rhythm in patients with mitral valve disease, the long-term results of this procedure have not been determined. METHODS: We echocardiographically studied 94 consecutive patients with mitral valve disease before, as well as early (3.1 +/- 3.3 months) and late (2.2 +/- 0.9 years) after, the maze procedure. Peak velocity and the time-velocity integral of the left ventricular (LV) diastolic filling wave during atrial contraction (A wave), as well as the atrial filling fraction (calculated as the ratio of the time-velocity integral of the A wave to total diastolic filling), were obtained from transmitral flow recordings. Peak A wave velocity > or =10 cm/s was considered to indicate echocardiographic evidence of effective atrial contraction. RESULTS: Regular rhythm with P waves was restored in 70 patients (74%) in the early stage and in 59 patients (63%, p = 0.09) in the late stage after the maze procedure. Forty-seven patients (50%) in the early stage and 36 patients (38%, p = 0.14) in the late stage showed effective atrial contraction by Doppler echocardiography. Left atrial (LA) and LV end-diastolic diameters significantly decreased after the procedure (from 59 +/- 13 to 48 +/- 7 mm, p < 0.01; and from 54 +/- 9 to 47 +/- 5 mm, p < 0.01, respectively) and did not show significant changes during the follow-up period. Once atrial contraction was resumed, its degree did not change between the early and late stages after the maze procedure (17 +/- 6% vs. 17 +/- 6% for atrial filling fraction). CONCLUSIONS: Sinus rhythm and atrial contraction recovered early after the maze procedure in most patients and were maintained for more than two years. Once active atrial contraction was resumed, the degree of contraction did not change thereafter. These results demonstrate that the maze procedure is effective for a long period in patients with mitral valve disease. |
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Authors:
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S Yuda; S Nakatani; Y Kosakai; M Yamagishi; K Miyatake |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 37 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-05-09 Completed Date: 2001-05-21 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1622-7 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, National Cardiovascular Center, Osaka, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Atrial Fibrillation / etiology*, physiopathology, surgery*, ultrasonography Atrial Function* Chronic Disease Diastole Disease Progression Echocardiography, Doppler Electrocardiography Female Follow-Up Studies Heart Conduction System / physiopathology, surgery*, ultrasonography Humans Male Middle Aged Mitral Valve Insufficiency / complications* Mitral Valve Stenosis / complications* Myocardial Contraction* Treatment Outcome Ventricular Function, Left |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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