| Randomized study of surgical isolation of the pulmonary veins for correction of permanent atrial fibrillation associated with mitral valve disease. | |
| | |
MedLine Citation:
|
PMID: 19619795 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: Chronic permanent atrial fibrillation is often due to mitral valve disease. The Cox maze procedure is the gold standard for treating this arrhythmia. Simpler techniques and ablation methods should have their efficacy tested in clinical practice. Our objective was to evaluate the effectiveness of surgical pulmonary vein isolation as compared with the Cox maze procedure. METHODS: Sixty patients were randomly assigned to control group, modified maze group (Cox maze III), and surgical isolation of the pulmonary veins (SPVI) group from July 1999 to October 2004. All patients had mitral valve lesions treated concomitantly. Preoperative characteristics were similar between groups. RESULTS: There were 4 deaths: 3 in the Cox maze group and 1 in the SPVI group (P = .31). The Cox maze group presented longer times of extracorporeal circulation and myocardial ischemia (P < .001). The relative risk of late postoperative development of atrial fibrillation was 0.07 in the SPVI group (P < .001; 95% confidence intervals: 0.02-0.27) and 0.195 in the Cox maze group (P = .002; 95% confidence intervals: 0.07-0.56) as compared with the control group. No difference was found between the SPVI and Cox maze groups concerning prevention of atrial fibrillation recurrence (relative risk: 0.358; P = .215; 95% confidence intervals: 0.08-1.67). CONCLUSIONS: The modified Cox maze procedure and surgical pulmonary vein isolation were similarly effective in restoring sinus or regular rhythm in permanent atrial fibrillation associated with mitral valve disease. These results favor the adoption of surgical isolation as a preferable technique, simpler and equally effective in controlling atrial fibrillation. The results also can bring further information for understanding the mechanisms involved in origins and treatment of chronic permanent atrial fibrillation. |
| | |
Authors:
|
Alvaro Albrecht; Renato A K Kalil; Luciana Schuch; Rogério Abrahão; Joao Ricardo M Sant'Anna; Gustavo de Lima; Ivo A Nesralla |
Related Documents
:
|
19796345 - Initial experience with the high-density mesh ablation catheter for pulmonary vein isol... 11603445 - Predictors for atrial transport function after mini-maze operation. 19521755 - Typical atrial flutter can effectively be treated using single one-minute cryoapplicati... 9458145 - When and how to report results of surgery on atrial fibrillation. 11308285 - Pumping injection of sodium hyaluronate for patients with non-reducing disc displacemen... 19696805 - Intravitreal bevacizumab vs triamcinolone acetonide for macular oedema due to central r... |
Publication Detail:
|
Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: The Journal of thoracic and cardiovascular surgery Volume: 138 ISSN: 1097-685X ISO Abbreviation: J. Thorac. Cardiovasc. Surg. Publication Date: 2009 Aug |
Date Detail:
|
Created Date: 2009-07-21 Completed Date: 2009-07-30 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 0376343 Medline TA: J Thorac Cardiovasc Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 454-9 Citation Subset: AIM; IM |
Affiliation:
|
Department of Cardiovascular Surgery, Instituto de Cardiologia do Rio Grande do Sul/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, Brazil. editoracao-pc@cardiologia.org.br |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Atrial Fibrillation / etiology, surgery* Cardiac Surgical Procedures / adverse effects Female Heart Valve Diseases / complications* Humans Male Middle Aged Mitral Valve* / surgery Postoperative Complications Pulmonary Veins / surgery* Young Adult |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Postoperative recurrence and the role of adjuvant chemotherapy in patients with pulmonary large-cell...
Next Document: Skeletal myoblast sheet transplantation improves the diastolic function of a pressure-overloaded rig...