title: New procedure for treatment of atrial fibrillation in patients with valvular heart disease.
abstract: Patients with valvular heart disease suffer from atrial fibrillation for more than 12 months after valve surgery and have a low probability of remaining in sinus rhythm. We performed an intra-operative procedure similar to surgical maze ІІІ procedure for conversion of this arrhythmia to sinus rhythm. We did this study to evaluate the efficacy of this procedure to restore the sinus rhythm in patients with valvular heart disease. 28 patients with valvular heart disease and chronic persistent atrial fibrillation underwent different combinations of valve surgery and concomitant reduction of left and right atrial size and resection of both atrial auricles in Shahid Madani cardiothoracic center from September 2004 to October 2008. The procedure for atrial fibrillation treatment was performed with cardiopulmonary bypass and after mitral valve replacement. There was one in-hospital death postoperatively because of respiratory failure, but no other complication till 6 months after the operation. Out of 28 patients, 23 were in sinus rhythm one week after the operation, one patient had junctional rhythm after the operation that restored to sinus rhythm and 4 patients had persistent atrial fibrillation. During the 12-month follow up, atrial fibrillation was corrected in 82.14%. Doppler echocardiography in these patients with sinus rhythm demonstrated good atrial contractility. This procedure on both atria is effective and less invasive than the original maze procedure to eliminate the atrial fibrillation, and can be performed in patients with valvular heart disease without increasing the risk of operation.
authors.affiliation: Department of Cardiovascular Surgery, Shahid Madani Hospital, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. drsafaie@yahoo.com
authors.forename: Naser
authors.initials: N
authors.lastname: Safaie
authors.forename: Nasrollah
authors.initials: N
authors.lastname: Maghamipour
authors.forename: Ahmad Reza
authors.initials: AR
authors.lastname: Jodati
authors.forename: Ata
authors.initials: A
authors.lastname: Mahmoodpoor
authors.forename: Leila
authors.initials: L
authors.lastname: Dashtaki
authors.forename: Masoud
authors.initials: M
authors.lastname: Hakimzadeh
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects / Q000401:mortality; D002315:Cardiopulmonary Bypass; D015150:Echocardiography, Doppler; D005260:Female; D006349:Heart Valve Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000401:mortality / Q000601:surgery*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007492:Iran; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome