Initial experience with a modified left atrial maze procedure concomitant to cardiac surgery

Area of Science:

• Cardiovascular Surgery
• Electrophysiology
• Cardiac Arrhythmias

Background:

• The Cox-Maze-III operation demonstrated the efficacy of surgical treatment for atrial fibrillation.
• Surgical maze procedures are complex and time-consuming, necessitating simplified modifications.
• Concomitant left atrial maze procedures with mitral valve surgery and ablation technologies are viable for many patients.

Purpose of the Study:

• To evaluate the efficacy and safety of a modified maze procedure performed concurrently with other cardiac surgeries.
• To assess the success rate of radiofrequency ablation for pulmonary vein isolation and atrial lesion creation.
• To determine the restoration of sinus rhythm and atrial transport function post-procedure.

Main Methods:

• A modified maze procedure was performed on 42 patients undergoing cardiac surgery between November 1999 and June 2000.
• Pulmonary vein isolation was achieved using radiofrequency ablation, with additional ablation lines to the mitral valve annulus.
• Left atrial appendage resection was performed, and patient outcomes were assessed post-discharge and at 3 months.

Main Results:

• At discharge, 76.2% of patients exhibited a regular supraventricular rhythm.
• At 3-month follow-up, 85.7% of patients were in sinus rhythm, with restored atrial transport function.
• Three patients required ongoing antiarrhythmic medication.

Conclusions:

• The modified maze procedure is a practical, rapid, and dependable surgical option when combined with cardiac interventions.
• Early outcomes indicate a high success rate for this technique in managing atrial fibrillation.
• Further long-term follow-up is necessary to confirm sustained efficacy.