title: Cox-maze IV cryoablation and postoperative heart failure in mitral valve surgery patients.
abstract: OBJECTIVE
  The indications for and the risk and benefit of concomitant surgical ablation for atrial fibrillation (AF) have not been fully delineated. Our aim was to survey whether the Cox-maze IV procedure is associated with postoperative heart failure (PHF) or other adverse short-term outcomes after mitral valve surgery (MVS).
  
  
  METHODS
  Consecutive patients with AF undergoing MVS with (n = 50) or without (n = 66) concomitant Cox-maze IV cryoablation were analysed regarding perioperative data and one-year mortality.
  
  
  RESULTS
  The patients in the Maze group were younger, were in lower NYHA classes, had better right ventricular function and had lower pulmonary artery pressure. The Maze group had 30 min longer median cross-clamp time (CCT) and 50% had PHF compared with 33% in the No-maze group, p = 0.09. Two patients in the No-maze group died within one year of surgery. Congestive heart failure (OR 4.3 [CI 95%: 1.8-10], p < 0.0001) and CCT (OR 1.03 [CI 95%: 1.01-1.04], p = 0.001) were associated with PHF.
  
  
  CONCLUSIONS
  The current data cannot exclude that concomitant cryoablation increases the risk for PHF, possibly by increasing the cross clamp time.
authors.affiliation: a Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences , Linköping University , Linköping , Sweden.|b Department of Cardiothoracic Surgery , Heart & Medicine Centre , Linköping , Sweden.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Boano
authors.affiliation: a Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences , Linköping University , Linköping , Sweden.|c Department of Clinical Physiology , Heart & Medicine Centre , Linköping , Sweden.
authors.forename: Meriam
authors.initials: M
authors.lastname: Åström Aneq
authors.affiliation: a Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences , Linköping University , Linköping , Sweden.|c Department of Clinical Physiology , Heart & Medicine Centre , Linköping , Sweden.
authors.forename: Jennie
authors.initials: J
authors.lastname: Kemppi
authors.affiliation: a Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Faculty of Health Sciences , Linköping University , Linköping , Sweden.|b Department of Cardiothoracic Surgery , Heart & Medicine Centre , Linköping , Sweden.
authors.forename: Farkas
authors.initials: F
authors.lastname: Vánky
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D003250:Constriction; D003452:Cryosurgery / Q000009:adverse effects* / Q000401:mortality; D016208:Databases, Factual; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology; D006349:Heart Valve Diseases / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology / Q000601:surgery*; D016017:Odds Ratio; D061646:Operative Time; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: Atrial fibrillation; mitral valve; outcome; postoperative heart failure