Can we change the operative criteria for the MAZE procedure combined with valve surgery in the era of radiofrequency devices?
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Suguru Kubota, MD, PhD · Hiroshi Sugiki, MD, PhD Satoru Wakasa, MD, PhD · Tomonori Ooka, MD, PhD Tsuyoshi Tachibana, MD, PhD Shigeyuki Sasaki, MD,
- چاپ و سال / کشور: 2010
Description
Purpose. After radiofrequency (RF) ablation became available, the indication of MAZE procedure conducted with bipolar RF was expanded. We examined the effi - cacy and feasibility of the RF MAZE procedure in valve surgery and identifi ed the predictors of atrial fi brillation (AF) recurrence. Methods. Forty-four patients had permanent AF at the time of operation and underwent a biatrial RF MAZE procedure. Univariate and multivariate analysis for the predictor of permanent AF recurrence and follow-up studies were performed. Results. Of the patients, 37 (84.1%) were in non-AF rhythm at discharge and 25 (80.6%) were at the latest follow-up (mean, 2.1 پ} 1.2 years). In stepwise multivariate analysis, left atrial dimension (LAD) > 61.5 mm was an independent predictor of early-term recurrence of AF (P = 0.006) and late-term recurrence (P = 0.038) as well. F-wave voltage <0.1 mV was signifi cant in univariate analysis but was not signifi cant in multivariate analysis for predictor of late-term AF recurrence. Avoidance of AF in the late term was 56% for LAD > 60 mm whereas it was 91% for LAD . 60 mm (P = 0.043), 67% for F-wave < 0.1 mV compared to 100% for F-wave .0.1 mV (P = 0.031), and 43% for LAD > 60 mm and F-wave < 0.1 mV compared to 91% for LAD . 60 mm and/or F-wave . 0.1 mV (P = 0.016), respectively. Although avoidance of AF in the late term was lower in patients with LAD > 60 mm or F-wave < 0.1 mV, more than half of these patients were free from AF in the late term. Conclusion. LA size was assumed to be a simple and strong predictor of recurrent AF in this procedure. Predictive criteria that had been widely employed for the پgcut-and-sewپh MAZE procedure accompanied with valve surgery can be expanded in the MAZE procedure with RF devices.
Gen Thorac Cardiovasc Surg (2011) 59:406–412 DOI 10.1007/s11748-010-0770-0 Received: 10 August 2010 / Accepted: 21 December 2010
