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Related Concept Videos

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Related Experiment Video

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Multislice computed tomography accurately quantifies left atrial size and function after the MAZE procedure.

Kazuo Yamanaka1, Masatoshi Fujita, Kazuhiko Doi

  • 1Division of Cardiovascular Surgery, Takeda Hospital, Japan.

Circulation
|July 6, 2006
PubMed
Summary

The MAZE procedure effectively restores sinus rhythm in patients with chronic atrial fibrillation (AF) and mitral valve disease. However, it results in significantly worse left atrial (LA) mechanical function compared to coronary artery bypass grafting (CABG).

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Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • The MAZE procedure aims to restore sinus rhythm and left atrial (LA) mechanical function in chronic atrial fibrillation (AF) patients.
  • The precise impact of MAZE on LA geometry and wall motion, particularly in patients with co-existing mitral valve disease, requires further elucidation.

Purpose of the Study:

  • To investigate the effects of the MAZE procedure on left atrial (LA) size and mechanical function in patients with chronic atrial fibrillation (AF) and mitral valvular disease.
  • To compare LA geometry and function post-MAZE with a control group undergoing coronary artery bypass graft (CABG) surgery.

Main Methods:

  • A study involving 14 patients who underwent MAZE for chronic AF and mitral valve surgery and 10 patients who underwent CABG.
  • Quantitative evaluation of LA volume and booster function using multislice computed tomography (MSCT) at an average of 15-18 months post-surgery.
  • MAZE procedure performed using endocardial radiofrequency ablation.

Main Results:

  • All MAZE patients achieved freedom from AF and atrial arrhythmias post-procedure.
  • While LA volumes were comparable between groups, the MAZE group exhibited significantly reduced LA ejection fraction (15% vs. 26%, P=0.004).
  • LA wall motion was significantly worse in the MAZE group compared to the CABG group, despite contraction towards the geometric center in both.

Conclusions:

  • Radiofrequency ablation MAZE is a safe and effective treatment for restoring sinus rhythm in chronic AF patients with mitral valve disease.
  • Chronic AF associated with mitral valve disease leads to diffuse deterioration of LA mechanical function.
  • Further MSCT studies are necessary to sequentially assess LA function after MAZE, with and without concomitant mitral valve surgery.