Comparison of Immediate Results of Left Atrial and Classical Maze Iii Procedures

Yuriy Shneyder, Georgy Antipov, Andrey Mikheev, Mikhail Isayan, Pavel Zolotukhin

FSBI Federal Center of High Medical Technologies, Kaliningrad, Russian Federation, KALININGRAD, Russia

Date, time and location: 2018.05.26 08:30, Congress Hall, 2F–A

Abstract

Objective: To evaluate the immediate results of the left atrial maze as compared to classical maze III procedure.

Methods: From 2012 to 2016, 217 patients underwent a classical maze III procedure - group 1. Since 2017, only the left atrial maze has been performed- group 2. In total, during 2017 year, 97 procedures were performed (mean age 62 ± 8.2 years, 52 men). Preoperative status of patients significantly didn’t differ in two groups. The duration of AF before surgery was 43.2 ± 35.2 months. Most patients had permanent form of AF. In the second group surgical isolation of the pulmonary veins was performed with the addition of line to the mitral valve using cryoablation. Concomitant procedures were: valvular correction, CABG and combination. Average period of observation (group 2) 4.9 ± 2.3 months. ECG, Holter monitoring data, ECHO-data, need for repeated RFA interventions, pacemaker implantation, SF-36 questionnaire were evaluated.

Results: The 30-day mortality was 3.7% (8 patients) in group 1 and 3.1% (3 patients) in group 2. Data at the end of hospital stage (group 1): the restoration of sinus rhythm 151 (72.5%) pts, AF – 15(7.1%) pts, other rhythm disturbances- 23(11%) pts, pacemaker implantation - 20 (9.6%) pts. Data at the end of hospital stage (group 2): the restoration of sinus rhythm 77 (79.4%) pts, AF – 7(7.2%) pts, other rhythm disturbances- 6(6.2%) pts, pacemaker implantation - 9(9.2%) pts. In group 1 repeated RFA – 7(3.3%), embolic events – 4(1.6%) pts and in group 2 – 2(2.1%), and – 1(1%) pts respectively.

Conclusions: Isolated left atrial intervention in the treatment of AF shows good efficacy. The main predictors of the failure of the procedure are the duration of AF and the size of the LA (p <0.05). Further analysis requires remote data for the second group of patients.