Article Sidebar

PDF
Date Published: 31/10/2022
Abstract Views: 225
Views PDF: 196
DOI: https://doi.org/10.47972/vjcts.v39i.806
Issue
Vol. 39
Section
Research Article
How to Cite
Thuy, N. T., Son, D. H., & Huu, N. C. (2022). Surgery results of Cox-Maze IV procedure in treatment for atrial fibrillation combined with valve disease at Cardiovascular Center, E hospital. The Vietnam Journal of Cardiovascular and Thoracic Surgery, 39, 82-89. https://doi.org/10.47972/vjcts.v39i.806

Surgery results of Cox-Maze IV procedure in treatment for atrial fibrillation combined with valve disease at Cardiovascular Center, E hospital

Nguyen Tran Thuy, Dam Hai Son, Nguyen Cong Huu

Main Article Content

Abstract

Introduction: Atrial fibrillation is a major cause of stroke, heart failure, and sudden death and is often associated with valve disease. The Maze procedure using the unipolar and bipolar radiofrequency devices is often combined with valvular surgery, especially mitral valve, to treat atrial fibrillation.


Method: Cross-sectional descriptive study; 40 patientsss were treated for atrial fibrillation by COX-MAZE procedure combined with heart valve surgery in 2020-2021 at Cardiovascular Center- E Hospital.


Result: In 40 patients, 23 males (57.5%), 17 females (42.5%), mean age 53.6 ± 8.3 (36-68) years. Mean time to dêtct atrial fibrillation 3.27 (1-9) years. 05 cases (12.5%) were preopration stroke history. Mean left atrial diameter before surgery 49.2 ± 10.1 (21-70) mm, thrombus in left atrial appendage was 8 cases (20%). All patients had mitral valve disease, accompanied by aortic valve disease 4 cases (10%) and tricuspid valve regurgitation 13 cases (32.5%). 100% of patients underwent COX-MAZE procedure. The rates of free from AF and sinus recovery after surgery 31 cases (77.5%). 02 patients (5%) sinus node dysfunction and 04 patients (10%) atrioventricular block I-II degree but they did not require temporary pacemaker placement, and recovered in 1-3 weeks.


Conclusion: The Maze procedure by unipolar devices alone and combination with bipolar devices are effective and safe in patient atrial fibrillation combined with valvular surgery, especially mitral valve surgery.

Article Details

Keywords

Atrial fibrillation, Maze procedure, mitral valve disease, mitral valve repair/replacement

References

1. Fuster V, Rydén LE, Cannom DS, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society. Circulation. 2006;114(7). doi:10.1161/CIRCULATIONAHA.106.177292
2. Cox JL, Ad N, Palazzo T, et al. Current Status of the Maze Procedure for the Treatment of Atrial Fibrillation. Semin Thorac Cardiovasc Surg. 2000;12(1):15-19. doi:10.1016/S1043-0679(00)70011-6
3. Cox JL. The surgical treatment of atrial fibrillation. IV. Surgical technique. J Thorac Cardiovasc Surg. 1991;101(4):584-592.
4. Comas GM, Imren Y, Williams MR. An Overview of Energy Sources in Clinical Use for the Ablation of Atrial Fibrillation. Semin Thorac Cardiovasc Surg. 2007;19(1):16-24. doi:10.1053/j.semtcvs.2007.01.009
5. Damiano RJ, Badhwar V, Acker MA, et al. The CURE-AF trial: A prospective, multicenter trial of irrigated radiofrequency ablation for the treatment of persistent atrial fibrillation during concomitant cardiac surgery. Heart Rhythm. 2014;11(1):39-45. doi:10.1016/j.hrthm.2013.10.004
6. Ad N, Cheng DCH, Martin J, et al. Surgical Ablation for Atrial Fibrillation in Cardiac Surgery a Consensus Statement of the International Society of Minimally Invasive Cardiothoracic Surgery (ISMICS) 2009. Innov Technol Tech Cardiothorac Vasc Surg. 2010;5(2):74-83. doi:10.1097/imi.0b013e3181d72939
7. Raman J, Ishikawa S, Storer MM, Power JM. Surgical radiofrequency ablation of both atria for atrial fibrillation: results of a multicenter trial. J Thorac Cardiovasc Surg. 2003;126(5):1357-1365. doi:10.1016/S0022-5223(03)01185-1
8. Deneke T. Efficacy of an additional MAZE procedure using cooled-tip radiofrequency ablation in patients with chronic atrial fibrillation and mitral valve disease. A randomized, prospective trial. Eur Heart J. 2002;23(7):558-566. doi:10.1053/euhj.2001.2841
9. Abreu Filho CAC, Lisboa LAF, Dallan LAO, et al. Effectiveness of the Maze Procedure Using Cooled-Tip Radiofrequency Ablation in Patients With Permanent Atrial Fibrillation and Rheumatic Mitral Valve Disease. Circulation. 2005;112(9_supplement). doi:10.1161/CIRCULATIONAHA.104.526301
10. Gillinov AM, Gelijns AC, Parides MK, et al. Surgical Ablation of Atrial Fibrillation during Mitral-Valve Surgery. N Engl J Med. 2015;372(15):1399-1409. doi:10.1056/NEJMoa1500528
11. Byrd GD, Prasad SM, Ripplinger CM, et al. Importance of Geometry and Refractory Period in Sustaining Atrial Fibrillation: Testing the Critical Mass Hypothesis. Circulation. 2005;112(9_supplement). doi:10.1161/CIRCULATIONAHA.104.526210
12. Stulak JM, Sundt TM, Dearani JA, Daly RC, Orsulak TA, Schaff HV. Ten-year Experience With the Cox-Maze Procedure for Atrial Fibrillation: How Do We Define Success? Ann Thorac Surg. 2007;83(4):1319-1324. doi:10.1016/j.athoracsur.2006.11.007
13. Damiano RJ, Schwartz FH, Bailey MS, et al. The Cox maze IV procedure: Predictors of late recurrence. J Thorac Cardiovasc Surg. 2011;141(1):113-121. doi:10.1016/j.jtcvs.2010.08.067
14. Badhwar V, Rovin JD, Davenport G, et al. Left Atrial Reduction Enhances Outcomes of Modified Maze Procedure for Permanent Atrial Fibrillation During Concomitant Mitral Surgery. Ann Thorac Surg. 2006;82(5):1758-1764. doi:10.1016/j.athoracsur.2006.05.044.