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Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
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[Intractable Atrial Arrhythmia after Maze Procedure].
Shinji Yamada1, Fumiaki Kuwabara, Yuji Mashiko
1Department of Cardiovascular Surgery, Nagoya Ekisaikai Hospital, Nagoya, Japan.
Kyobu Geka. the Japanese Journal of Thoracic Surgery
|December 3, 2020
Summary
The Maze procedure is a standard treatment for atrial fibrillation, but persistent arrhythmias may require catheter ablation (ABL). Ablating the cavo-tricuspid isthmus and LSPV-LAA ridge effectively treated drug-resistant atrial arrhythmias post-Maze.
Area of Science:
- Cardiac Surgery
- Electrophysiology
- Arrhythmology
Background:
- The Maze procedure is the gold standard for treating atrial fibrillation, offering high cure rates.
- Persistent or drug-resistant atrial arrhythmias can occur after the Maze procedure.
- Electrophysiological study (EPS) and catheter ablation (ABL) are valuable diagnostic and therapeutic options for these refractory arrhythmias.
Purpose of the Study:
- To examine cases requiring catheter ablation (ABL) after Maze procedures in patients with mitral valve surgery.
- To report on the effectiveness of specific ablation targets in managing post-Maze atrial arrhythmias.
Main Methods:
- Review of patients who underwent Maze procedure for mitral valve surgery with concurrent atrial arrhythmia.
- Electrophysiological study (EPS) to diagnose persistent atrial arrhythmias.
- Catheter ablation (ABL) targeting the cavo-tricuspid isthmus (CTI) and the left superior pulmonary vein-left atrial appendage (LSPV-LAA) ridge.
Main Results:
- Two typical cases requiring ABL after Maze procedure were identified.
- Successful ablation of the CTI in the right atrium was effective.
- Effective ablation of the LSPV-LAA ridge in the left atrium was also demonstrated.
Conclusions:
- Catheter ablation (ABL) is an effective treatment for persistent, drug-resistant atrial arrhythmias following the Maze procedure.
- Targeting the cavo-tricuspid isthmus (CTI) and the LSPV-LAA ridge are effective strategies in managing these complex arrhythmias.
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