Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Surgical Outcomes of Cox-maze IV Procedure Using Bipolar Irrigated Radiofrequency Ablation and Cryothermy in Valvular Heart Disease

  • Kim, Jun-Sung (Department of Thoracic and Cardiovascular Surgery, Boramae Hospital, Seoul National University College of Medicine) ;
  • Lee, Jae-Hang (Department of Thoracic and Cardiovascular Surgery, Bundang Hospital, Seoul National University College of Medicine) ;
  • Chang, Hyoung-Woo (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, Kyung-Hwan (Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul National University College of Medicine)
  • Received : 2010.09.24
  • Accepted : 2010.11.15
  • Published : 2011.02.05
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Abstract

Background: We evaluated the efficacy of Cox-maze IV procedure using bipolar irrigated radiofrequency ablation and cryothermy in chronic atrial fibrillation associated with valvular heart disease. Material and Methods: From November 2005 to June 2009, ninety four patients have undergone valvular heart surgery with Cox-maze IV procedure. Preoperative duration of atrial fibrillation was $7.6{\pm}6.5$ years and follow-up duration was $22.7{\pm}12.3$ months. Results: There were two (2.1%) postoperative deaths not related to maze procedure. Two cerebrovascular accidents, five low cardiac output syndromes and two permanent pacemaker implantations have occurred after surgery. Preoperative ejection fraction on echocardiography was $55.3{\pm}8.1%$ and ejection fraction of postoperative six month was $54.7{\pm}6.5%$. Left atrial size of preoperative and postoperative were $61.5{\pm}11.6\;mm$ and $53.1{\pm}8.4\;mm$ at each. Freedom from atrial fibrillation rate at postoperative six-month was 80.7% and the cases of recurrence of atrial fibrillation after six months were three (3.3%). Risk factors for failure or recurrence of maze procedure were old age (p=.010) and preoperative moderate or severe tricuspid regurgitation (p=.033). Conclusion: The Cox-maze IV procedure using RFBP2 and cryothermy is quite safe and freedom from atrial fibrillation at postoperative 6 month was 82.5%. Risk factors for failure or recurrence of atrial fibrillation after Cox-maze IV were old age and preoperative over moderate tricuspid regurgitation.

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References

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