| Long-term outcome of combined valve repair and maze procedure for nonrheumatic mitral regurgitation. | |
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MedLine Citation:
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PMID: 20363476 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The long-term outcomes of combined mitral repair and maze procedure for patients with nonrheumatic mitral regurgitation and chronic atrial fibrillation were evaluated. METHODS: Between June 1992 and December 2008, 187 patients underwent a combined mitral repair and maze procedure. The mean follow-up period was 7.4 ± 4.3 years. Chordal reconstruction was performed in 69 patients, leaflet resection in 91, edge-to-edge leaflet suture in 30, and ring annuloplasty in 156. In addition, a cryo-maze procedure was applied in 110, and a Cox-Kosakai maze and radiofrequency maze were applied in the others. RESULTS: There were 2 operative deaths and the 15-year survival was 71%. The 15-year freedom from greater than grade 3 mitral regurgitation was 61%; rates of freedom from heart failure (New York Heart Association class ≥ III) and reoperations were 79% and 91%, respectively. Cardiac function was improved and left ventricular size was decreased significantly postoperatively. Multivariate analysis showed that a large left ventricular diastolic diameter (≥65 mm) was an independent risk factor for recurrent mitral regurgitation. Eleven thromboembolic episodes (0.79%/patient-year) were detected during follow-up examinations, of which 7 occurred in patients with recurrent atrial fibrillation. Sinus rhythm was regained in 86% after 6 months and in 63% after 15 years. Multivariate analysis showed that a small-voltage f wave was an independent risk factor for AF recurrence. CONCLUSIONS: A combined mitral valve repair and maze procedure provided low rates of morbidity and mortality and led to well-preserved cardiac function. Left ventricular diastolic diameter and f-wave voltage can be accurate predictors of good long-term outcome. |
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Authors:
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Tomoyuki Fujita; Junjiro Kobayashi; Koichi Toda; Hiroyuki Nakajima; Yutaka Iba; Yusuke Shimahara; Toshikatu Yagihara |
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Publication Detail:
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Type: Journal Article Date: 2010-04-03 |
Journal Detail:
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Title: The Journal of thoracic and cardiovascular surgery Volume: 140 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-16 Completed Date: 2010-12-23 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
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Languages: eng Pagination: 1332-7 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Cardiovascular Surgery, National Cardiovascular Center, Osaka, Japan. tfujita@hsp.ncvc.go.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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complications,
mortality,
surgery*,
ultrasonography Cardiac Surgical Procedures / methods*, mortality Catheter Ablation / methods, mortality Chronic Disease Echocardiography Female Humans Male Middle Aged Mitral Valve Insufficiency / complications, mortality, surgery*, ultrasonography Proportional Hazards Models Reconstructive Surgical Procedures / methods, mortality Reoperation Survival Rate Treatment Outcome |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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