Surgical management for patients with long-standing persistent (LSP) AF and giant left atria (GLA) associated with mitral valve diseases remains a challenge. We aimed to assess the efficacy of the cut-and-sew maze procedure (CSM) in this subgroup of patients, in terms of maintenance of sinus rhythm (SR), atrial function, and to identify the operative risks of this procedure. A total of 229 patients with LSP-AF underwent CSM at our institution from December 2013 to October 2017. Patients were divided into 2 groups based on LA diameter: NGLA group (<65 mm, n = 171), GLA group (≥65 mm, n = 58). Patients with GLA were propensity score matched to patients without GLA resulting in 45 pairs of patients. Early death occurred in 1 (2.2%) in GLA group and no deaths in NGLA group (P = 0.315). Early complications did not differ significantly between the 2 groups. The GLA group showed similar rates of SR on and off antiarrhythmic drugs compared with NGLA group at 2 years (86.36% vs 93.9%, P = 0.338; 81.82% vs 90.91%, P = 0.322). At 2 years, LA contraction was comparable between patients with and without GLA (81.81% vs 90.9%, P = 0.322). Right atrial contraction recovery rate was 96% in NGLA group, and 86.36% in GLA group (P = 0.138). Concomitant CSM is effective and feasible for restoration of SR and atrial contraction, for patients with LSP-AF and GLA associated with mitral valve diseases with acceptable operative risks.
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http://dx.doi.org/10.1053/j.semtcvs.2019.05.004 | DOI Listing |
Surg Open Sci
December 2023
General Surgery Department, San Giacomo Hospital, Via Edilio Raggio 12, Novi Ligure, Alessandria, Italy.
Introduction: A growing need for proper geriatric assessment and short-stay surgical programs supported by the availability of less invasive approaches, even in ambulatory settings, is being recognized as a feasible option for breast cancer patients with comorbidities who are usually distressed after standard surgery with ordinary hospitalization. Few studies have been conducted in Italian breast centers with dedicated techniques and approach for frail patients with breast diseases due to a jeopardized approach to ambulatory surgery among institutions.
Methods: This study included 58 women diagnosed with breast disease and comorbidities between March 2019 and December 2022 at the Ambulatory of Senology of San Giacomo Hospital in Novi Ligure (AL, Italy) and Civil Hospital in Ovada (AL, Italy).
Heart Lung Circ
November 2022
Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China.
Background: The cut-and-sew maze (CSM) procedure has an excellent efficacy for the elimination of long-standing persistent atrial fibrillation (AF) concomitant with mitral valve surgery. Because of the complexity and prolongation of cardiopulmonary bypass, CSM has not been widely used. The aim of this study was to examine a modified maze procedure that preserves the "cut-and-sew" procedure in the left atrium and uses cryoablation in the right atrium along with cavotricuspid isthmus.
View Article and Find Full Text PDFSemin Thorac Cardiovasc Surg
October 2021
Department of Cardiovascular Surgery, General Hospital of Northern Theater Command, Shenyang, Liaoning Province, China.
In this trial, we sought to evaluate the efficacy and safety of the addition of the Maze performed by cryoablation (CryoMaze) to the mitral valve surgeries. The trial is a randomized, single-center trial to determine whether CryoMaze was noninferior to cut-and-sew maze procedure (CSM) in patients with persistent or long-standing persistent atrial fibrillation (AF), with a 15% margin to establish noninferiority. The primary endpoint was freedom from AF off antiarrhythmic drugs (AADs) at 12 months.
View Article and Find Full Text PDFJ Cardiothorac Surg
May 2020
Department of Cardiovascular Surgery. Jinling Hospital, Nanjing University, School Medicine, 305 East Zhongshan Road, Nanjing, 210002, PR China.
Objectives: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in patients with heart valve disease. Our aim was to summarize our experience and evaluate the efficacy and safety of the Cox maze III procedure combined with valve surgery in patients with AF.
Methods: A retrospective, observational analysis was performed for all consecutive patients underwent maze III procedure combined with valve surgery between October 2015 and June 2019.
Gac Med Mex
April 2020
Instituto Mexicano del Seguro Social, Hospital de Cardiología 34, Departamento de Cirugía Cardiaca, Nuevo León, México.
Introduction: The cox-maze III procedure is designed to eliminate atrial fibrillation (AF).
Objective: To determine the relationship of left atrial (LA) postoperative size after undergoing the Cox-maze III procedure.
Method: From July 2012 to April 2016, 50 patients with primary mitral valve disease and concomitant AF were operated on.
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