Key result
Concomitant Cox-maze IV cryoablation during mitral valve surgery was associated with postoperative heart failure in 50% of patients compared to 33% in the control group (p=0.09).
Why the study?
Does concomitant Cox-maze IV cryoablation increase the risk of postoperative heart failure in patients with atrial fibrillation undergoing mitral valve surgery?
Cohort (n=116)
No
Does concomitant Cox-maze IV cryoablation increase the risk of postoperative heart failure in patients with atrial fibrillation undergoing mitral valve surgery?
Absolute Event Rate: 50% vs 33%
p-value: p=0.09
Concomitant Cox-maze IV cryoablation during mitral valve surgery may increase the risk of postoperative heart failure, potentially driven by prolonged cross-clamp times.
May signal higher postoperative heart failure risk with concomitant cryoablation; leaves open whether prolonged cross-clamp time drives this in observational data.
OBJECTIVE: The indications for and the risk and benefit of concomitant surgical ablation for atrial fibrillation (AF) have not been fully delineated. Our aim was to survey whether the Cox-maze IV procedure is associated with postoperative heart failure (PHF) or other adverse short-term outcomes after mitral valve surgery (MVS). DESIGN: Consecutive patients with AF undergoing MVS with (n = 50) or without (n = 66) concomitant Cox-maze IV cryoablation were analysed regarding perioperative data and one-year mortality. RESULTS: The patients in the Maze group were younger, were in lower NYHA classes, had better right ventricular function and had lower pulmonary artery pressure. The Maze group had 30 min longer median cross-clamp time (CCT) and 50% had PHF compared with 33% in the No-maze group, p = 0.09. Two patients in the No-maze group died within one year of surgery. Congestive heart failure (OR 4.3 [CI 95%: 1.8-10], p < 0.0001) and CCT (OR 1.03 [CI 95%: 1.01-1.04], p = 0.001) were associated with PHF. CONCLUSION: The current data cannot exclude that concomitant cryoablation increases the risk for PHF, possibly by increasing the cross clamp time.
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Boano et al. (2016) conducted a cohort in Preoperative nonparoxysmal atrial fibrillation undergoing mitral valve surgery (n=116). Cox-maze IV biatrial cryoablation vs. No concomitant ablation procedure was evaluated on Postoperative heart failure (p=0.09). Concomitant Cox-maze IV cryoablation during mitral valve surgery was associated with postoperative heart failure in 50% of patients compared to 33% in the control group (p=0.09).
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