Surgical treatment of arrhythmias in adults with congenital heart defects

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Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

Alessandro Giamberti1, Massimo Chessa, Raul Abella

  • 1Pediatric Cardiology and Cardiac Surgery Department- GUCH Unit, IRCCS Policlinico San Donato, San Donato M.se (MI), Italy. alegia@hotmail.com

International Journal of Cardiology
|August 11, 2007
PubMed

Insights

Intraoperative irrigated radiofrequency ablation (IRA) effectively controls arrhythmias in adults with congenital heart disease (CHD). This safe procedure is a viable option for patients undergoing cardiac surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Adults with congenital heart disease (CHD) face significant morbidity and mortality from supraventricular and ventricular arrhythmias.
  • Intraoperative ablation presents an alternative to complex surgical Cox-Maze procedures for managing arrhythmias in this population.

Purpose of the Study:

  • To evaluate the preliminary experience and outcomes of intraoperative monopolar irrigated radiofrequency ablation (IRA) in adult patients with CHD undergoing elective cardiac surgery.

Main Methods:

  • Fifty adult patients with CHD underwent intraoperative IRA during cardiac surgery between September 2002 and [End Date - not specified in abstract].
  • Procedures included 31 right-sided Maze, 13 Cox-Maze III, and 6 right ventricular ablations, with 14 patients receiving pacemakers.

Main Results:

  • Two perioperative deaths (4%) occurred, unrelated to ablation. The remaining 48 patients survived with NYHA class I or II status at a mean 28-month follow-up.
  • Forty-three patients maintained spontaneous sinus rhythm; others achieved rhythm control with medication, atrial fibrillation management, or pacemaker dependence.
  • No complications were reported directly from the intraoperative IRA procedure.

Conclusions:

  • Intraoperative IRA is a safe and effective method for managing arrhythmias in adults with CHD.
  • Consideration of intraoperative IRA is recommended when transcatheter ablation is unsuccessful or during planned elective cardiac surgery for CHD patients.
Abstract

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