Key result
A novel left-sided mini-maze procedure via the left atrial appendage resulted in stable sinus rhythm in 58.33% of later patients versus 18.18% of early patients, demonstrating a learning curve.
Why the study?
Does the left-sided mini-maze procedure via the left atrial appendage improve freedom from atrial fibrillation in patients undergoing CABG or aortic valve replacement?
Cohort (n=23)
Does the left-sided mini-maze procedure via the left atrial appendage improve freedom from atrial fibrillation in patients undergoing CABG or aortic valve replacement?
The novel mini-maze procedure via the left atrial appendage is safe and feasible during CABG or aortic valve replacement, but its efficacy is limited by a significant learning curve and it appears less effective than the traditional Cox-maze III procedure.
Hypothesis-generating for LAA mini-maze during CABG or AVR; leaves open comparative efficacy versus Cox-maze III.
This study presents a novel way to perform the mini-maze procedure through the left atrial appendage. By this way, the usual additional incision of the intra-atrial groove is avoided, especially in patients receiving coronary artery bypass grafting (CABG) or aortic valve replacement without mitral valve disease. We retrospectively analysed 23 consecutive patients who received this novel mini-maze procedure between 2009 and 2011. In recognition of a learning curve, we divided the patients into two groups (Group 1: Patients 1-11 versus Group 2: Patients 12-23), according to the date of operation. In Group 2, 7 patients (58.33%) were completely free of atrial fibrillation at the time of the follow-up. In Group 1, only 2 (18.18%) patients were successfully treated resulting in a stable sinus rhythm at the time of the follow-up. The mini-maze procedure performed through the left atrial appendage is a safe and feasible technique; however, it seems to be less effective than the Cox-maze III procedure and is associated with a learning curve.
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Ismail et al. (2014) conducted a cohort in Atrial fibrillation (n=23). Left-sided mini-maze procedure via the left atrial appendage vs. Early experience (Group 1, patients 1-11) was evaluated on Freedom from atrial fibrillation / stable sinus rhythm at follow-up. A novel left-sided mini-maze procedure via the left atrial appendage resulted in stable sinus rhythm in 58.33% of later patients versus 18.18% of early patients, demonstrating a learning curve.
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