Objective : Review of early and late results of surgical treatment of atrial fibrillation as a concommittant procedure during open heart surgery.
Methods : Prospective data analysis of patients undergoing combined open heart surgery and Minimaze technique for atrial fibrillation. Early postoperative standard protocol and outpatient clinic visit at 1, 3 and 6 months for late follow-up.
Results : Between November 1999 and Oct 2004, 220 pts did undergo Minimaze procedure. 58% or male patients (127/93).
MV surgery was performed in 118 pts (53.6%). MV and TV surgery in 36 pts (16.4 %) and MV with AV in 26 pts (11.8 %). CABG only was performed in 12 pts (5.5 %) and other cardiac surgery in 6 pts (2.6%).
Port-Access approach was used in 104 pts (47.4 %), median sternotomy in 110 pts (50%).
Pts presented with a LA diameter mean 5.5 cm and 65 pts (29.5 %) presented with intermittent atrial fibrillation.
Energy sources used were unipolar RF frequency in 173 pts (78.6 %). Bipolar RF frequency in 16 pts (7.3 %), Microwave in 5 pts (2.3 %), cryo in 24 pts (10.9 %) and Ultrasound in 2 pts (1.9 %).
There were no major technique related complications. All patients received class III antiarrhythmic drugs for 6 months. No atrial fibrillation rhythm was present in 69.3 % of the pts at hospital discharge and 69.9 % at follow-up. PM implantation was necessary in 23 pts (10.5 %). Neurologic complications were present in 7 pts (5 %).
Conclusion : Association of surgical therapy for atrial fibrillation during open heart surgery does not increase peri operative morbidity and mortality and offers very satisfactory late results.