Thorac Cardiovasc Surg 2015; 63(03): 243-249
DOI: 10.1055/s-0034-1383719
Original Cardiovascular
Georg Thieme Verlag KG Stuttgart · New York

Long-Term Outcomes after Mitral Valve Repair for Degenerative Mitral Regurgitation with Persistent Atrial Fibrillation

Takashi Murashita
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
,
Yukikatsu Okada
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
,
Hideo Kanemitsu
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
,
Naoto Fukunaga
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
,
Yasunobu Konishi
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
,
Ken Nakamura
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
,
Tadaaki Koyama
1   Department of Cardiovascular Surgery, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
› Author Affiliations
Further Information

Publication History

06 February 2014

15 May 2014

Publication Date:
15 July 2014 (online)

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.

 
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