Objectives: retrospective non-randomized study evaluating sinus rhythm of concomitant mini-MAZE and valve surgery.
Methods: We reviewed 36 patients with atrial fibrillation ( 35 chronic and 1 paroxysmal) operated between 26/1/2005 and 17/7/2007. They all underwent combined mini-Maze and valve surgery. The mean age was 62.2 years, ranging from 46 till 85 years. Gender distribution of 15 males and 21 females. The mean duration of atrial fibrillation was 18.13 months. There was a minimal follow-up of 6 months. We saw the following distribution of concomitant cardiac interventions: MVP = 18; MVR = 6; AVR = 2; TVP = 1; MVP + TVP = 1; MVP + AVR = 2; MVP + TVP + AVR =1; MVP + CABG = 3. 4 double chamber and 32 single left chamber ablations were performed. Twelve operations were done with only bipolar ablation en 24 with combined bipolar and monopolar ablation.
Results: At discharge 19 patients (53%) had normal sinus rhythm, 13 (36%) were in atrial fibrillation, 3 (8%) were pacemaker dependent and one (3%) had atrial flutter. After 6 months, we found 28 ( 78%) patients in sinus rhythm, 3 (8%) had a permanent pacemaker, 3(8%) remained in atrial flutter and only 2 (6%) remained in atrial fibrillation. In our group we performed 16 (44%) electrical cardio conversions. During our follow-up we had to do 3 PVI with restoration of sinus rhythm. Amiodarone was used in 13 patients in postoperative setting, 12 patients were on β-blockade. No patient was lost at six months follow-up, with 0% peri-operative mortality.
Conclusions: At 6 months follow-up, concomitant mini-Maze and valve surgery with an additional PVI can give us a 78% success rate to restore normal sinus rhythm.