Open Heart Surgery with MAZE Procedure Modifications: Long-term Outcome

Dmitrii I. Cherkashin, Oleg Sapelnikov, Igor Grishin, Alla Partigulova, Olga Nikolaeva, Darin Ardus, Sergey Korolev, Renat Akchurin

Russian cardiology research center, Moscow, Russia

Date, time and location: 2018.05.25 13:30, Exhibition area, 1st Floor. Zone – A

Abstract

Background: MAZE procedure is an effective surgical method in atrial fibrillation (AF) treatment. Moreover, nowadays we are all aware of its modifications.

Purpose: We conducted comparative analysis of two approaches of Cryo-MAZE procedure: long-term results.

Methods: We include fifty-two (52) patients with atrial fibrillation (AF) in conjunction with coronary artery disease or mitral valve disease, where surgical treatment was performed. Average age was 60,1±10,25 years, prevalence of men was admitted (59,6%). In all cases we performed Cryo-MAZE procedure with one-stage myocardium revascularization or mitral-valve surgery. Patients were divided into 2 groups according to Cryo-MAZE procedure type – one group underwent pulmonary vein (PV) isolation with line at left atrium roof and ablation of mitral isthmus (L1), another group of patients had isolation of LA posterior wall in addition.

Results: It is worth mentioning, that both groups were comparable including the majority of demographic characteristics. Isolation of posterior wall didn’t prolong the operation time and on-pump significantly. In this way, Cryo-MAZE procedure directly lasted 18±1,7 min in the first group and 20±2,1 min in the second group (p – 0,398); the whole operation time was 192±24 min and 199±19 min (p – 0,435) and artificial circulation time was 103±12 min and 104±10 min (р-0,547).

In 12 months,group of additional posterior wall isolation had no AF recurrences in 81,8% versus 57,9% (p – 0,087), and by third year of follow-up the efficacy of ablation in the second group significantly exceeded results of the first group (75,8% versus 47,4 % p – 0,048).

Conclusion: Isolation of the left atrial posterior wall may considerably improve efficacy of surgical treatment, which was demonstrated in significant decrease of AF recurrences during the whole follow-up period.