Operative results after the Cox/maze procedure combined with a mitral valve operation

Izumoto, Hiroshi; Kawazoe, Kohei; Kuwabara, Hiroto; Kamata, Junya

doi:10.1016/s0003-4975(98)00590-6

Cited by 48 publications

(18 citation statements)

References 19 publications

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“…In this context, the perioperative mortality in the 2 groups (7%) is in keeping with previously published figures. 12,21,22 Functional capacity improved in both groups, reflecting a beneficial hemodynamic effect derived from correction of mitral regurgitation. However, within the RFA group, patients converting to sinus rhythm achieved significantly longer SWT than their counterparts remaining in atrial fibrillation.…”

Section: Commentmentioning

confidence: 93%

Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

Doukas¹,

Samani²,

Alexiou³

et al. 2005

JAMA

161

121

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Context Although left atrial radiofrequency ablation (RFA) is increasingly used for the treatment of chronic atrial fibrillation during mitral valve surgery, its efficacy to restore sinus rhythm and any resulting benefits have not been examined in the context of an adequately powered randomized trial. Objective To determine whether intraoperative RFA of the left atrium increases the long-term restoration of sinus rhythm and improves exercise capacity. Design, Setting, and Patients Randomized, double-blind trial performed in a single UK tertiary referral center with enrollment between December 2001 and November 2003. A total of 101 patients referred for mitral valve surgery with at least 6 months' history of uninterrupted atrial fibrillation were assessed for eligibility; 97 were enrolled. Patients were followed up for 12 months. Intervention Patients were randomly assigned to undergo mitral valve surgery and RFA of the left atrium (n=49) or mitral valve surgery alone (controls; n=48). Main Outcome Measures The primary outcome measure was presence of sinus rhythm at 12 months; secondary measures were patient functional status and exercise capacity (assessed by shuttle-walk test), left atrial contractility, and left atrial and left ventricular dimension and function and plasma levels of B-type natriuretic peptide. Results At 12 months, sinus rhythm was present in 20 (44.4%) of 45 RFA patients and in 2 (4.5%) of 44 controls (rate ratio, 9.8; 95% CI, 2.4-86.3; PϽ.001). Restoration of sinus rhythm in the RFA group was accompanied by a greater improvement in mean (SD) shuttle-walk distance compared with controls (ϩ94 [102] m vs ϩ48 [82] m; P=.003) and a greater reduction in the plasma level of B-type natriuretic peptide (−104 [87] fmol/mL vs −51 [82] fmol/mL; P=.03). Patients randomized to receive RFA had similar rates of postoperative complications and deaths as control patients. Conclusions Radiofrequency ablation of the left atrium during mitral valve surgery for continuous atrial fibrillation significantly increases the rate of sinus rhythm restoration 1 year postoperatively, improving patient exercise capacity. On the basis of its efficacy and safety, routine use of RFA of the left atrium during mitral valve surgery may be justified. Trial Registration ClinicalTrials.gov Identifier: NCT00238706.

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Section: Commentmentioning

confidence: 93%

Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

Doukas¹,

Samani²,

Alexiou³

et al. 2005

JAMA

161

121

View full text Add to dashboard Cite

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“…The independent risk factors to receive warfarin medication in the late period are older age, longer preoperative AF duration, and rheumatic mitral disease. In several studies older patient age, longer preoperative AF duration, and rheumatic valvulopathy have been reported to be risk factors for AF recurrence after the Maze procedure [8][9][10][11][12][13]. In these regards, long-term warfarin therapy is mainly determined by AF recurrence, which is strongly influenced by baseline risk factors of AF recurrence.…”

Section: Commentmentioning

confidence: 99%

Long-Term Outcomes of the Maze Procedure Combined With Mitral Valve Repair: Risk of Thromboembolism Without Anticoagulation Therapy

Hwang

Yoo

Kim

et al. 2015

The Annals of Thoracic Surgery

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“…This procedure is reported to have several clinical benefits, including eliminating the symptoms of irregular rhythms, and incorporating atrial contractility into cardiac output, thus improving overall haemodynamics 15 16. Restoration of atrial contraction may further eliminate the source of mural thrombus formation 2 9 15 16…”

Section: Discussionmentioning

confidence: 99%

Mitral valve replacement with or without a concomitant Maze procedure in patients with atrial fibrillation

Kim

Yun

et al. 2010

Heart

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Operative results after the Cox/maze procedure combined with a mitral valve operation

Cited by 48 publications

References 19 publications

Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

Long-Term Outcomes of the Maze Procedure Combined With Mitral Valve Repair: Risk of Thromboembolism Without Anticoagulation Therapy

Mitral valve replacement with or without a concomitant Maze procedure in patients with atrial fibrillation

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