Korean J Thorac Cardiovasc Surg.  2008 Jun;41(3):313-319.

The Influence of Simplified Surgical Procedures on the Surgical Treatment for Atrial Fibrillation with using the Cut-and-Sew Technique

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Chonbuk National University Medical School, Korea. jobchoi@cuh.co.kr
  • 2Department of Thoracic and Cardiovascular Surgery, Wonkwang University School of Medicine, Korea.

Abstract

BACKGROUND: The Cox maze-III procedure is considered as the most effective surgical treatment for atrial fibrillation. Because this procedure takes a long time and it complicates the concomitant cardiac surgery, some surgeons perform a left atrial maze procedure or pulmonary vein isolation only to reduce the operation time. This study was performed to evaluate how the modified procedures, with using cut-and-sew techniques, can influence the treatment of atrial fibrillation. MATERIAL AND METHOD: Between Feb 1999 and June 2005, 40 patients (17 males and 23 females) with organic heart disease and atrial fibrillation underwent the Cox maze-III procedure (23), the left atrial maze procedure (10) or pulmonary vein isolation (7). The cut-an-sew technique was used to ablate the atrial wall, but cryoablation was used instead of the cut-and-sew technique for the coronary sinus and the inferior wall between the pulmonary vein and the mitral annulus. RESULT: After a mean follow-up period of 50.0+/-21.6 months, all (100%) of the 23 patients who underwent the Cox maze-III procedure had regular sinus or atrial rhythm conversion, and 7 (70%) of 10 with a left atrial maze procedure and 4 (57.1%) of 7 with pulmonary vein isolation had regular sinus or atrial rhythm conversion (p=0.002).
CONCLUSION
To obtain a high conversion rate from atrial fibrillation to a regular sinus rhythm or a regular atrial rhythm, the standard Cox maze-III procedure should be performed in both atria. The limited modified procedures like the left atrial maze procedure or pulmonary vein isolation may reduce the cure rate of atrial fibrillation.

Keyword

Arrhythmia surgery; Surgical procedures; Treatment outcome

MeSH Terms

Atrial Fibrillation
Coronary Sinus
Cryosurgery
Follow-Up Studies
Heart Diseases
Humans
Male
Pulmonary Veins
Thoracic Surgery
Treatment Outcome
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