title: Modified maze procedure combined with mitral valve surgery via septal-superior approach.
abstract: Although a septal-superior approach provides excellent exposure of the mitral valve, it requires novel strategies for concomitant ablation in patients with atrial fibrillation. Utilizing a combination of bipolar radiofrequency and cryothermy, we developed a novel technique for creating a biatrial lesion set via a septal-superior approach during mitral valve surgery. We treated 10 patients with functional mitral regurgitation and permanent atrial fibrillation with rhythm disturbance for a mean 87 months. A modified maze was successfully accomplished via a septal-superior approach in all. The mean follow-up period was 18 months, during which permanent pacemaker implantation was necessary for one due to sinus bradycardia. Sustained sinus rhythm, including atrial or atrial-based paced rhythm, was present in all immediately after surgery, in 70% at discharge, in 80% at 1 year after surgery, and in 90% at the latest follow-up examination. Our novel technique using a modified maze procedure in combination with mitral valve surgery via a septal-superior approach was safe and useful for eliminating atrial fibrillation, with a relatively low frequency of sinus node dysfunction.
authors.affiliation: Department of Cardiovascular Surgery, Japan Labor Health and Welfare Organization, Osaka Rosai Hospital, Sakai, Osaka, Japan. s.kainuma@hotmail.co.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kainuma
authors.forename: Takenori
authors.initials: T
authors.lastname: Yokota
authors.forename: Koichi
authors.initials: K
authors.lastname: Toda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Taniguchi
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D003131:Combined Modality Therapy; D003452:Cryosurgery / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery*; D008944:Mitral Valve Insufficiency / Q000150:complications / Q000601:surgery*; D016896:Treatment Outcome