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Left atrial function after Cox's maze operation concomitant with mitral valve operation

T Itoh1, H Okamoto, T Nimi

  • 1Department of Thoracic Surgery, Yokkaichi Municipal Hospital, Japan.

The Annals of Thoracic Surgery
|August 1, 1995
PubMed
Summary

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Concomitant maze operations with mitral valve surgery may not eliminate atrial fibrillation in elderly patients, showing incomplete left atrial contraction. This impacts ventricular filling and atrial function post-surgery.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Electrophysiology

Background:

  • Atrial fibrillation is a common complication following mitral valve operations.
  • The study investigates the efficacy of a concomitant maze operation in preventing atrial fibrillation.
  • Mitral valve surgery often leads to atrial fibrillation, impacting patient outcomes.

Purpose of the Study:

  • To evaluate left atrial function after a Cox's maze operation performed concurrently with mitral valve surgery.
  • To assess the impact of concomitant maze procedures on atrial contractility and ventricular filling.
  • To determine if the maze procedure eliminates atrial fibrillation in this patient cohort.

Main Methods:

  • Transthoracic echocardiography was used to assess left atrial function in 10 patients (38-67 years) undergoing combined mitral valve and maze operations.

Related Experiment Videos

  • Key indices measured included the A/E ratio and atrial filling fraction (AFF) from transmitral flow.
  • A control group of 7 patients who had undergone coronary artery bypass grafting was included for comparison.

    • Main Results:

    • Patients who had the concomitant maze operation showed significantly lower A/E ratios and AFF compared to controls.
    • Both A/E ratio and AFF correlated inversely with age in the maze group.
    • The maze group exhibited a larger left atrial volume index and reduced active emptying volume index.

    Conclusions:

    • Left atrial contraction is detectable but incomplete in elderly patients after a concomitant maze and mitral valve operation.
    • The procedure may not fully restore atrial function, particularly in older individuals with dilated atria.
    • Further research is needed to optimize maze procedures for preventing atrial fibrillation post-mitral valve surgery.