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Freedom from atrial arrhythmias after classic maze III surgery: a 10-year experience

Philippe K E W Ballaux1, Guillaume S C Geuzebroek, Norbert M van Hemel

  • 1Heart Lung Center Utrecht, Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands. phballaux@yahoo.com

The Journal of Thoracic and Cardiovascular Surgery
|December 5, 2006
PubMed

Insights

The Maze III procedure offers persistent freedom from atrial arrhythmias for most patients, with long-term success predicted by rhythm at one year and left atrium size. This surgical intervention demonstrates lasting efficacy in managing supraventricular arrhythmias.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Atrial fibrillation (AF) is a common arrhythmia requiring effective treatment.
  • The Maze III procedure is a surgical intervention for AF.
  • Assessing the long-term outcomes of the Maze III procedure is crucial for patient management.

Purpose of the Study:

  • To evaluate the persistence of favorable outcomes after the Maze III procedure.
  • To determine the occurrence of new atrial arrhythmias post-procedure.
  • To assess sinus node dysfunction following the Maze III procedure.

Main Methods:

  • A retrospective analysis of 203 patients undergoing the Maze III procedure between 1993 and 2003.
  • Data collection included preoperative, in-hospital, and follow-up information.
  • Patients were categorized into lone AF (139) or AF with concomitant cardiac surgery (64).

Main Results:

  • No 30-day postoperative mortality was observed.
  • Mean follow-up was 4.0 ± 2.6 years, with 6% mortality (2% cardiac-related).
  • Freedom from supraventricular arrhythmias at follow-up was 80% (lone AF) and 64% (concomitant AF).
  • Freedom from stroke was 100% (lone AF) and 97% (concomitant AF).
  • Predictors of success included 1-year rhythm (P < .001) and preoperative left atrium dimension (P = .028).

Conclusions:

  • The Maze III procedure demonstrates persistent favorable outcomes, particularly freedom from supraventricular arrhythmias, in most patients for at least 4 years.
  • Rhythm at one-year follow-up and preoperative left atrium size are significant predictors of long-term success.
Abstract

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