title: Assessment of thromboembolism after the Cox-Maze procedure for chronic atrial fibrillation secondary to mitral valve lesion.
abstract: OBJECTIVE
  To assess the occurrence of late thromboembolism after surgical repair of chronic atrial fibrillation (AF) simultaneously with repair of mitral valve using the Cox-Maze procedure.
  
  
  METHODS
  69 patients underwent Cox 3 procedure, with no cryoablation simultaneously with mitral valvuloplasty or prosthesis. Mean age was 49.9+/-13.2 years. Mean follow-up was of 31.7+/-19 months. Types of lesion were as follows: 33 (48%) stenoses, 23 (33%) insufficiencies, and 13 (19%) double lesions. Procedures were: 64 (93%) valvuloplasties, 3 (4%) biological and 2 (3%) mechanical prosthesis placement. There were 9 (13%) patients with previous systemic embolism and 2 (3%) had left atrial thrombi.
  
  
  RESULTS
  Early mortality was 7% and late 1%. 2 patients (3%) were reoperated for mitral placement. At last evaluation, 10 patients (15%), were in AF. The remaining 59 (85%) were either in sinus / atrial rythm (74%) or under pacing (12%). There were no occurrence of early or late, systemic or pulmonary embolism. Permanent anticoagulation was employed in 16 cases, 10 in regular rythm and 6 in AF. The remaining 47 (75%), 2 in AF and 45 in regular rythm, did not receive anticoagulants.
  
  
  CONCLUSIONS
  These results are in accordance with others series, where the occurrence of embolism was rare after maze procedure. Permanent systemic anticoagulation seems to be unnecessary in those cases.
authors.affiliation: Instituto de Cardiologia do Rio Grande do Sul, Fundação Universitária de Cardiologia, SP, Brasil.
authors.forename: Renato A K
authors.initials: RA
authors.lastname: Kalil
authors.forename: Paula L M
authors.initials: PL
authors.lastname: Nesralla
authors.forename: Gustavo G
authors.initials: GG
authors.lastname: Lima
authors.forename: Tiago L
authors.initials: TL
authors.lastname: Leiria
authors.forename: Rogério
authors.initials: R
authors.lastname: Abrahao
authors.forename: Paulo
authors.initials: P
authors.lastname: Moreno
authors.forename: Paulo R
authors.initials: PR
authors.lastname: Prates
authors.forename: João R M
authors.initials: JR
authors.lastname: Sant'Anna
authors.forename: Ivo A
authors.initials: IA
authors.lastname: Nesralla
mesh_terms: D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000209:etiology / Q000601:surgery*; D001938:Brazil / Q000453:epidemiology; D002908:Chronic Disease; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D013923:Thromboembolism / Q000453:epidemiology*