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Long-term outcome following concomitant mitral valve surgery and Cox maze procedure for atrial fibrillation
| Content Provider | Scilit |
|---|---|
| Author | Ad, Niv Holmes, Sari D. Massimiano, Paul S. Rongione, Anthony J. Fornaresio, Lisa M. |
| Copyright Year | 2018 |
| Description | Journal: Journal of Thoracic and Cardiovascular Surgery Atrial fibrillation (AF) is associated with increased early and long-term morbidity/mortality following valve surgery. This study examined long-term influence of concomitant full Cox maze (CM) and mitral valve procedures on freedom from atrial arrhythmia and stroke. This sample comprised patients who underwent CM with a mitral valve procedure (N = 473). Data on rhythm, medication status, and clinical events captured according to Heart Rhythm Society guidelines at 6, 9, 12, 18, and 24 months and yearly thereafter up to 7 years. Mean age was 65 years, mean left atrium size was 5.3 cm, and 15% had paroxysmal AF. Perioperative stroke occurred in 2 patients (0.4%) and operative mortality was 2.7% (n = 13). Return to sinus rhythm regardless of antiarrhythmic drugs at 1, 5, and 7 years was 90%, 80%, and 66%. Sinus rhythm off antiarrhythmic drugs at 1, 5, and 7 years was 83%, 69%, and 55%. Freedom from embolic stroke at 7 years was 96.6% (0.4 strokes per 100 patient-years) with a majority of patients off anticoagulation medication. Greater odds of atrial arrhythmia recurrence during 7 years was associated with longer AF duration (odds ratio [OR], 1.07; P = .001), whereas lower odds were associated with cryothermal energy only (OR, 0.64; P = .045) and greater surgeon experience (OR, 0.98; P = .025). This study suggests that the addition of CM to mitral valve procedures, even with a high degree of complexity, did not increase operative risk. In long-term follow-up, the CM procedure demonstrated acceptable rhythm success, reduced AF burden, and remarkably low stroke rate. Individual surgeon experience and training may notably influence long-term surgical ablation for AF success. |
| Related Links | http://www.jtcvs.org/article/S0022522317324893/pdf https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933444/pdf |
| Ending Page | 994 |
| Page Count | 12 |
| Starting Page | 983 |
| ISSN | 00225223 |
| e-ISSN | 1097685X |
| DOI | 10.1016/j.jtcvs.2017.09.147 |
| Journal | Journal of Thoracic and Cardiovascular Surgery |
| Issue Number | 3 |
| Volume Number | 155 |
| Language | English |
| Publisher | Elsevier BV |
| Publisher Date | 2018-03-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Thoracic and Cardiovascular Surgery Atrial Fibrillation |
| Content Type | Text |
| Resource Type | Article |
| Subject | Pulmonary and Respiratory Medicine Surgery Cardiology and Cardiovascular Medicine |
