Predictors of sinus rhythm restoration after cox maze procedure concomitant with other cardiac operations

Kamata, Junya; Kawazoe, Kohei; Izumoto, Hiroshi; Kuwabara, Hiroto; Shiina, Yoshitaka; Sato, Yoshihiro; Nakai, Kenta; Ohkubo, Takayoshi; Tsuji, Ichiro; Hiramori, Katsuhiko

doi:10.1016/s0003-4975(97)00139-2

Cited by 108 publications

(100 citation statements)

References 19 publications

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“…12) Fukada also suggested that fibrosis of the atrial myocardium caused by a long duration of AF and rheumatic inflammation might contribute to a poor outcome of the maze procedure. 13) In our series, 5 patients needed [14][15][16][17] which were also confirmed in this study. Although AF can be treated by the left-sided maze procedure, there is an increased risk of initiating atrial flutter, which is usually of right atrial origin.…”

Section: Discussionsupporting

confidence: 85%

Cryosurgical Left-sided Maze Procedure in Patients with Valvular Heart Disease: Medium-term Results

Sakamoto

Takakura

Onoguchi

et al. 2011

ATCS

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Purpose: We evaluated medium-term results of the left-sided maze procedure using cryoablation in patients with valvular heart disease. Methods: We retrospectively evaluated 111 patients with valvular heart disease who underwent the cryosurgical left-sided maze procedure. The mean follow-up period was 36.8 ± 24.9 months, and the mean duration of atrial fibrillation was 5.6 ± 6.0 years. The primary surgical procedure was mitral valve replacement in 42 patients, mitral valve plasty in 28, aortic valve replacement in 25, and combined aortic and mitral replacement or plasty in 16. Results: The 7-year actuarial survival rate was 82.9 ± 11.4% for patients in sinus rhythm and 87.0 ± 7.0% for patients with atrial fibrillation, showing no difference between the two groups (p = 0.236). At final follow-up, 86 out of 111 patients (77.5%) remained free from atrial fibrillation. Sinus rhythm was maintained in 26 of 42 patients (61.9%) in the mitral valve replacement group, 26 of 28 patients (92.9%) in the mitral valve plasty group, 15 of 17 patients (88.2%) in the aortic valve replacement group, and 18 of 24 patients (75.0%) in the combined aortic and mitral replacement or plasty group. The overall actuarial rate of freedom from atrial fibrillation at 5 years after surgery was 70.4 ± 6.0%. Conclusion: The cryosurgical left-sided maze procedure is a safe, simple, and excellent operation for medically refractory atrial fibrillation.

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Section: Discussionsupporting

confidence: 85%

Cryosurgical Left-sided Maze Procedure in Patients with Valvular Heart Disease: Medium-term Results

Sakamoto

Takakura

Onoguchi

et al. 2011

ATCS

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“…Low AF wave voltage in the V1 lead has been reported as a predictor of unsuccessful maze procedure, 4,5,7 but its predictive value was not documented in our study. A decrease in the voltage of AF waves on the 12-lead ECG correlates with the extent of atrial fibrosis; 28 however, the voltage on the 12-lead ECG is influenced by physiological conditions such as subcutaneous fat and the presence of fluid and gas in the thoracic cavity.…”

Section: Discussioncontrasting

confidence: 84%

Preoperative Left Atrial Emptying Fraction is a Powerful Predictor of Successful Maze Procedure

Aikawa

Watanabe

Shimokawa

et al. 2009

Circ J

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“…Most previous studies described some risk factors for late failure of sinus rhythm restoration such as the presence of an enlarged left atrium, fine fibrillation wave size, and longer duration of Af in cases of atrial fibrillation concomitant with mitral surgery. 20,22,24) On the basis of such results, in 1998, Fukada and associates 21) even went to the extent of suggesting that the indications for the maze procedure for Af associated with rheumatic mitral disease might need to be reconsidered.…”

Section: Discussionmentioning

confidence: 99%

Midterm Outcomes of Rheumatic Mitral Repair Versus Replacement

et al. 2008

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SUMMARYMitral repair is feasible for patients with degenerative or ischemic heart disease, however, the appropriateness of repair for rheumatic heart disease remains controversial. We compared our outcomes for primary isolated mitral repair versus replacement in an elderly population. From November 1997 to July 2005, mitral repair (group I) was performed in 33 patients while 59 underwent replacement (group II). Survival and risk factors were evaluated by Kaplan-Meier and Cox regression analysis. Mean age at operation for groups I and II was 49.7 ± 13.2 versus 58.1 ± 11.2 (P = 0.002). No statistically significant differences with regards to demographic parameters were observed except for there being fewer percutaneous transvenous mitral commissurotomy procedures and a lower severity of pulmonary hypertension in group I. Patients with a greater Wilkins score and more valvular calcification underwent replacement more often (P < 0.001). In-hospital mortality, ICU/hospital stay, and postoperative congestive heart failure functional class did not differ significantly. Major adverse cardiac events occurred in 13 and 19 patients, respectively (P = 0.50). There were 4 versus 6 late deaths (P = 0.74). Only two from group I underwent subsequent mitral reoperation. Kaplan-Meier overall survival and event-free survival at 5 years for groups I and II were 0.81 ± 0.08 versus 0.81 ± 0.06 (P = 0.90) and 0.52 ± 0.10 versus 0.51 ± 0.10 (P = 0.21), respectively. Old age, renal insufficiency, LVEF < 40%, and a history of stroke were poor predictors of patient survival. Compared with replacement, mitral repair for rheumatic heart disease was associated with a lower surgical mortality, higher repeat-surgery rate, and good survival. Rheumatic mitral valves should be repaired in select patients with appropriate valvular pathology. (Int Heart J 2008; 49: 565-576)

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Predictors of sinus rhythm restoration after cox maze procedure concomitant with other cardiac operations

Cited by 108 publications

References 19 publications

Cryosurgical Left-sided Maze Procedure in Patients with Valvular Heart Disease: Medium-term Results

Cryosurgical Left-sided Maze Procedure in Patients with Valvular Heart Disease: Medium-term Results

Preoperative Left Atrial Emptying Fraction is a Powerful Predictor of Successful Maze Procedure

Midterm Outcomes of Rheumatic Mitral Repair Versus Replacement

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