title: Right-sided Maze procedure for atrial tachyarrhythmias in congenital heart disease.
abstract: BACKGROUND
  Congenital heart disease (CHD) that causes right atrial dilatation is commonly associated with atrial flutter and/or fibrillation (AFl/F). To reduce late recurrence of AFl/F in patients undergoing repair of CHD, we utilized a concomitant right-sided maze procedure.
  
  
  METHODS
  From 1993 to 2003, 99 patients with CHD and associated AFl/F underwent a concomitant right-sided maze procedure at the time of CHD repair. Ages ranged from 9 to 72 years (median, 43 years). Atrial flutter and/or fibrillation was paroxysmal in 81 and chronic in 18; duration ranged from less than 1 month to 39.5 years (median, 2.9 years). Primary cardiac diagnoses were Ebstein anomaly (n = 47), other congenital tricuspid regurgitation (n = 19), univentricular heart (n = 11), isolated atrial septal defect (ASD, n = 8), tetralogy of Fallot (n = 8), and other (n = 6).
  
  
  RESULTS
  Other concomitant procedures included tricuspid valve repair or replacement (n = 70), ASD closure (n = 39), and pulmonary valve procedures (n = 18). There were 6 early deaths. At hospital dismissal, 83 patients were free of AFl/F and 63 were in sinus rhythm. Follow-up in 87 of the 93 early survivors extended up to 8 years (mean, 2.7 years). There were 4 late deaths, all from noncardiac causes. Of the 83 known late survivors, 77 (93%) were free of AFl/F. Eighty-two of the 83 survivors were in New York Heart Association class I or II.
  
  
  CONCLUSIONS
  In patients with AFl/F associated with CHD, a concomitant right-sided maze procedure at the time of intracardiac repair is effective in reducing late recurrent AFl/F. Most patients enjoy an excellent quality of life.
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Stulak
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Dearani
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Puga
authors.forename: Kenton J
authors.initials: KJ
authors.lastname: Zehr
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
authors.forename: Gordon K
authors.initials: GK
authors.lastname: Danielson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006348:Cardiac Surgical Procedures; D002648:Child; D015897:Comorbidity; D004437:Ebstein Anomaly / Q000453:epidemiology / Q000601:surgery; D005260:Female; D006330:Heart Defects, Congenital / Q000453:epidemiology* / Q000601:surgery; D006344:Heart Septal Defects, Atrial / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D013610:Tachycardia / Q000453:epidemiology* / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000453:epidemiology / Q000601:surgery