SHERP

Long-term results of the Cox-Maze III procedure for persistent atrial fibrillation associated with rheumatic mitral valve disease: 10-year experience

Cited 0 time in webofscience Cited 28 time in scopus
Authors
Kim, Kwan Chang; Cho, Kwang Ree; Kim, Yong-Jin; Sohn, Dae-Won; Kim, Ki-Bong
Issue Date
2006-12-13
Publisher
Elsevier
Citation
Eur J Cardiothorac Surg. 2007 Feb;31(2):261-6. Epub 2006 Dec 8.
Keywords
AdultAgedAtrial Fibrillation/etiology/*surgeryEpidemiologic MethodsFemaleHeart Atria/pathologyHeart Valve Diseases/*complicationsHumansMaleMiddle Aged*Mitral ValveRecurrenceRheumatic Heart Disease/*complicationsTreatment FailureTreatment OutcomeTricuspid Valve Insufficiency/complications
Abstract
OBJECTIVE: We evaluated the long-term results of the Cox-Maze III procedure (CM-III) for persistent atrial fibrillation (AF) associated with rheumatic mitral valve (MV) disease. METHODS: We analyzed 127 patients who underwent the CM-III combined with a rheumatic MV procedure between 1994 and 2004. In-hospital mortalities were excluded from the study. RESULTS: There were 10 late deaths and the mean follow-up duration was 7.1+/-2.8 years (range, 13 months to 11.5 years). Normal sinus rhythm was restored in 88.2% (112/127) after the CM-III. Right atrial contractility was demonstrable in 100% (112/112) and left atrial contractility in 68.8% (77/112) of the patients restored to sinus rhythm. Fifteen patients never regained sinus rhythm after the CM-III (AF treatment failure). Permanent pacemakers were implanted in 4.7% (6/127) of the patients during the follow-up. Late recurrence of AF developed in 34 of 112 patients at 44+/-27 months postoperatively, and sinus rhythm was restored in 29 of 34 patients by administration of an antiarrhythmic medication. Independent risk factors for late AF recurrence were longer duration of AF (>60 months) (odds ratio (OR)=2.758, p=0.025), increased left atrial size (OR=1.113, p=0.004). Freedom from AF recurrence was 93% at 1-year, 82% at 3 years, 71% at 5 years, and 63% at 7 years. Risk factors for AF treatment failure were longer duration of AF (>60 months) (p<0.001) and increased patient age (p=0.030). A higher prevalence of significant late tricuspid regurgitation was observed in patients with AF treatment failure and those with late AF recurrence. CONCLUSIONS: The CM-III for persistent AF associated with rheumatic MV disease demonstrated a progressively decreased cure rate during the follow-up period. Early surgical therapy, aggressive left atrial reduction, and correction of tricuspid regurgitation at the time of surgery may increase the long-term success rate.
ISSN
1010-7940 (Print)
Language
English
URI
http://ejcts.ctsnetjournals.org/cgi/content/full/31/2/261

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=17158057

http://hdl.handle.net/10371/15020
DOI
https://doi.org/10.1016/j.ejcts.2006.11.017
Files in This Item:
There are no files associated with this item.
Appears in Collections:
College of Medicine/School of Medicine (의과대학/대학원)Thoracic Surgery (흉부외과학전공)Journal Papers (저널논문_흉부외과학전공)
  • mendeley

Items in S-Space are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse