title: Long-term outcomes after mitral valve repair for degenerative mitral regurgitation with persistent atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) adversely affects surgical outcomes of mitral valve surgery. However, the long-term impact of Maze procedure has not been clear yet.
  
  
  METHODS
  We retrospectively investigated 159 patients who underwent mitral valve repair for degenerative mitral regurgitation with persistent AF between 1991 and 2010. The mean age of patients was 63.1 ± 10.5 years. After we started performing Maze procedure in 2002, 65 patients underwent concomitant Maze procedure. The median follow-up time was 7.5 years.
  
  
  RESULTS
  There was one operative death (0.63%). The overall survival rate was 91.0 ± 2.6% at 5 years and 79.1 ± 4.7% at 10 years. Survival was significantly better in patients who underwent Maze procedure than those who did not. The rate of freedom from AF in patients who underwent Maze procedure was 86.4 ± 4.5% at 1 year and 81.1 ± 5.6% at 5 years. The freedom rate from stroke was higher in patients who underwent Maze procedure than those who did not. Patients with postoperative AF had larger left ventricular systolic and diastolic diameters at follow-up and higher New York Heart Association functional class than patients without postoperative AF (1.4 ± 0.5 vs. 1.1 ± 0.3, p < 0.001).
  
  
  CONCLUSIONS
  Maze procedure can have a positive effect on long-term survival, freedom from stroke, and cardiac function.
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Murashita
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Yukikatsu
authors.initials: Y
authors.lastname: Okada
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Hideo
authors.initials: H
authors.lastname: Kanemitsu
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Naoto
authors.initials: N
authors.lastname: Fukunaga
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Konishi
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nakamura
authors.affiliation: Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan.
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Koyama
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000453:epidemiology*; D015897:Comorbidity; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000453:epidemiology* / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D020521:Stroke / Q000453:epidemiology; D016896:Treatment Outcome