Combined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term results

dc.contributor.authorAkpınar, Belhhan
dc.contributor.authorGüden, Mustafa
dc.contributor.authorSağbaş, Ertan
dc.contributor.authorSanisoğlu, İlhan
dc.contributor.authorÖzbek, Uğur
dc.contributor.authorCaynak, Barış
dc.contributor.authorBayındır, Osman
dc.date.accessioned2019-06-27T08:00:57Z
dc.date.available2019-06-27T08:00:57Z
dc.date.issued2003
dc.description.abstractObjective: The aim of this study was to assess the feasibility and effectiveness of irrigated radiofrequency (RF) modified Maze procedure through a port access approach during mitral valve surgery and evaluate early and mid-term results. Material and method: During a 16 months time period 67 patients with chronic atrial fibrillation (AF) eligible for port access mitral valve surgery were randomly assigned to either Group A in which they underwent a combined procedure (N = 33) or Group B in which a valve procedure alone was performed (N = 34). Both groups were similar in terms of age sex valve pathology duration of AF left atrial diameter and left ventricle function (P > 0.05). Four had undergone previous operations. Results: Median follow-up was 10 months for both groups 95% CI (9.18-10.8). One patient in each group died early postoperatively (3 and 2.9%). Two patients required reoperation for bleeding one in each group (3 and 2.9%). There were two conversions to right thoracotomy. In Group A freedom from AF was 100% at the end of the operation (76% sinus 24% pacemaker) Six and twelve months freedom from AF was 87.2 and 93.6% respectively. In Group B freedom from AF at the end of operation was 41%. At the end of 6 and 12 months freedom from AF was 9.4% (P = 0.0001). One patient in Group A required a permanent pacemaker (3%). During follow-up one patient in Group A died of non-cardiac causes (3%). In Group B there were two late deaths: one cardiac (2.9%) and one neurologic (2.9%). There were no thromboembolic events detected in Group A during follow-up whereas two patients in Group B suffered this complication (6% P = 0.081). At 12 months functional capacity had improved for patients in both groups (P < 0.0001). Conclusion: The combination of mitral valve surgery and irrigated RF Maze procedure was safe and efficient through a port access approach. There were no procedure related complications like esophageal or coronary artery injury. Early and mid-term results were favourable with 93.6% of patients free of AF at 1 year in comparison to the 9.4% of the control group. The data is not sufficient to reach any conclusions in terms of thromboembolic rates despite favourable results for the RF Maze group. Nevertheless in terms of feasibilty sinus rhythm restoration and overall outcome early results are encouraging and we advocate the use of the combined procedure through a port access approach. (C) 2003 Elsevier Science B.V. All rights reserved.en_US]
dc.identifier.citation71
dc.identifier.doi10.1016/S1010-7940(03)00258-6en_US
dc.identifier.endpage230
dc.identifier.issn1010-7940en_US
dc.identifier.issn1873-734Xen_US
dc.identifier.issn1010-7940
dc.identifier.issn1873-734X
dc.identifier.issue2
dc.identifier.pmid12895612en_US
dc.identifier.scopus2-s2.0-0042122497en_US
dc.identifier.scopusqualityQ1
dc.identifier.startpage223en_US
dc.identifier.urihttps://hdl.handle.net/20.500.12469/181
dc.identifier.urihttps://doi.org/10.1016/S1010-7940(03)00258-6
dc.identifier.volume24en_US
dc.identifier.wosWOS:000184979200009en_US
dc.identifier.wosqualityQ1
dc.language.isoenen_US
dc.publisherOxford University Pressen_US
dc.relation.journalEuropean Journal of Cardio-Thoracic Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectPort accessen_US
dc.subjectRadiofrequency ablationen_US
dc.subjectMazeen_US
dc.titleCombined radiofrequency modified maze and mitral valve procedure through a port access approach: early and mid-term resultsen_US
dc.typeArticleen_US
dspace.entity.typePublication

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