Left atrial maze procedure: a useful addition to other corrective operations.
BACKGROUND
The left atrial maze procedure is performed to treat atrial fibrillation (AF), mainly in patients with mitral valve disease. In this study, we assessed the midterm results of this procedure and clinically analyzed predicting factors for postoperative persistent AF.


METHODS
From June 1997 to May 2001, the left atrial maze procedure was performed on 31 patients (29 with mitral valve disease and 2 lone AF). For purposes of analysis, patients were divided postoperatively into those with persistent atrial fibrillation (AF) and those with sinus rhythm (SR), except 2 patients who required pacemaker implantation for sinus node dysfunction. Over a follow-up period of more than 12 months, patients were compared based on their preoperative and intraoperative variables.


RESULTS
At discharge, the success rate was 89.7%. The midterm rates (total of 94.9 patient-years of follow-up) of sinus rhythm and freedom from AF were 72.4% and 79.3%, respectively. There were significant differences in duration of AF, voltage of f-wave at first precordial lead of electrocardiogram, and cardiothoracic ratio between the SR and AF groups.


CONCLUSIONS
Our midterm results suggest that the left atrial maze procedure is an effective alternative adjunct procedure for elective open heart surgery to treat AF, depending upon the patient's clinical condition.
Department of Cardiovascular Surgery, Aomori Rousai Hospital, Hachinohe Aomori, Japan.
Norihiro
N
Kondo
Kenji
K
Takahashi
Masahito
M
Minakawa
Kazuyuki
K
Daitoku
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation; D005260:Female; D005500:Follow-Up Studies; D006325:Heart Atria; D006329:Heart Conduction System / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery; D008946:Mitral Valve Stenosis / Q000150:complications / Q000601:surgery; D011183:Postoperative Complications; D012008:Recurrence