Five-year experience with the maze procedure for atrial fibrillation.
Between September 25, 1987, and December 31, 1992, 75 patients (53 men, 22 women; average age, 52 years) underwent the maze procedure for the treatment of atrial fibrillation. Six patients had undergone a previous cardiac operation and 28% underwent concomitant cardiac procedures in addition to the maze procedure. One patient (1.3%) died 10 days after undergoing a combined maze procedure and Morrow procedure for the management of chronic atrial fibrillation and hypertrophic obstructive cardiomyopathy. Postoperative atrial pacemakers were required in 40%: 26% for preoperative sick sinus syndrome and 6% for iatrogenic injury of the sinus node, and 8% had pacemakers in place preoperatively. As of December 31, 1992, 65 patients had been followed up for at least 3 months after operation (range, 3 to 63 months). The maze procedure cured atrial fibrillation, restored atrioventricular synchrony, and preserved atrial transport function in 64 of 65 patients (98%). The procedure has been curative without the need for medications in 58 of 65 patients (89%) and with the need for medications in 6 of 65 (9%), with medications failing in only 1 of the 65 patients (2%). The results support the maze procedure as the treatment of choice in patients with medically refractory symptomatic atrial fibrillation.
Cox
J L
JL
Department of Surgery, Washington University School of Medicine, Barnes Hospital, St. Louis, Missouri 63110.
Boineau
J P
JP
Schuessler
R B
RB
Kater
K M
KM
Lappas
D G
DG
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000601:surgery*; D001282:Atrial Flutter / Q000601:surgery; D006348:Cardiac Surgical Procedures / Q000379:methods*; D002908:Chronic Disease; D017548:Echocardiography, Transesophageal; D004562:Electrocardiography; D005260:Female; D006325:Heart Atria / Q000503:physiopathology; D006329:Heart Conduction System / Q000000981:diagnostic imaging / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D016896:Treatment Outcome