Original articleAdult cardiacLong-Term Outcomes of Maze Procedure Plus Valve Replacement in Treating Rheumatic Valve Disease Resulting in Atrial Fibrillation
Section snippets
Study Population
From April 1995 to June 2004, 60 patients with RHVD and permanent AF referred for mitral (or mitral plus aortic) valve replacement were included in this study. The study was approved by the Investigational Review Board of Zhejiang University. All the cases validated informed consent from the patients or from their families. In terms of the study protocol, two types of concomitant CMP, either containing five localized cryoablations or using pure cut-and-sew, were performed according to a
Operative Data
Patients in the classic CMP group received 20 MVR and 2 mitral plus aortic valve replacements with 12 concomitant tricuspid annuloplasties and 3 extractions of left atrial thrombus. In the pure cut-and-sew group, 35 MVR and 3 mitral plus aortic valve replacements were performed with 23 tricuspid annuloplasties and 4 extractions of left atrial thrombus. Aortic cross-clamp and cardiopulmonary bypass times were insignificantly longer in the classic CMP group (Table 2).
Morbidity and Mortality
After the operations, 1
Comment
Atrial fibrillation occurs in as many as 50% of patients who undergo mitral valve surgery and is known to upset cardiac performance and prompts the risk of systemic emboli [12]. The Cox-Maze III procedure and concomitant valve surgery is recommended for patients with AF and associated mitral valve disease [13]. When performing CMP on patients with RHVD, particular considerations are required. On the one hand, these hearts have a substantial substrate for AF generation and continuation because
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