Abstract
Background Atrial fibrillation (AF) adversely affects surgical outcomes of mitral valve surgery.
However, the long-term impact of Maze procedure has not been clear yet.
Patients and Methods We retrospectively investigated 159 patients who underwent mitral valve repair for
degenerative mitral regurgitation with persistent AF between 1991 and 2010. The mean
age of patients was 63.1 ± 10.5 years. After we started performing Maze procedure
in 2002, 65 patients underwent concomitant Maze procedure. The median follow-up time
was 7.5 years.
Results There was one operative death (0.63%). The overall survival rate was 91.0 ± 2.6%
at 5 years and 79.1 ± 4.7% at 10 years. Survival was significantly better in patients
who underwent Maze procedure than those who did not. The rate of freedom from AF in
patients who underwent Maze procedure was 86.4 ± 4.5% at 1 year and 81.1 ± 5.6% at
5 years. The freedom rate from stroke was higher in patients who underwent Maze procedure
than those who did not. Patients with postoperative AF had larger left ventricular
systolic and diastolic diameters at follow-up and higher New York Heart Association
functional class than patients without postoperative AF (1.4 ± 0.5 vs. 1.1 ± 0.3,
p < 0.001).
Conclusion Maze procedure can have a positive effect on long-term survival, freedom from stroke,
and cardiac function.
Keywords
warfarin therapy - mitral valve surgery - outcomes
