Surgical outcomes of modified-maze procedures in adults with atrial septal defect

We examined the outcome of modified-maze procedures reflecting a single-center strategy in the treatment of atrial fibrillation (AF) associated with atrial septal defect (ASD) in adults.

A retrospective chart review was performed for 29 patients who underwent surgical ASD closure and 2 types of maze procedures (full and simplified maze procedures) for AF. The outcome related to the each procedure was examined. A Cox proportional hazards analysis was performed to assess the independent predictors of AF and atrial tachycardia (AT) recurrence.

The rates of freedom from AF and AT recurrence at 1 and 4 years were 86.6% and 72.2% in the full maze group and 78.5% and 62.8% in the simplified maze group, respectively (p = 0.70). The only risk factor for recurrence was the age at the time of surgery. A receiver operating characteristic curve analysis gave an optimum cut-off value of 58 years of age for predicting recurrence within 2 years (58.4% for ≥ 58 years versus 5.9% for < 58 years, p = 0.003).

Simplification of the maze procedure was not associated with AF or AT recurrence. The age at the time of surgery might be a clinical predictor of success or failure in adult patients.