The factor related to the outcome of maze procedure in mitral valve replacement surgery

Objective: To evaluate the factors related to the outcome of Maze surgery to remove atrial fibrillation in mitral valve replacement surgery at Hanoi Heart Hospital. Methods: Study on all patients with simple mitral valve disease and atrial fibrillation who were assigned to have mitral valve replacement surgery with Maze IV surgery from 01/2022 to 07/2023. Retrospective and prospective, non-controlled studies. Results: 51 patients (17 men, 34 women, mean age 55.22 ± 9.13) were eligible to participate in the study. The rate of sinus rhythm restoration at the time of discharge - 3 months - 6 months after surgery was 56.9% - 90.2% - 94.1%, respectively. Preoperative echocardiographic parameters have no predictive value in predicting the likelihood of sinus rhythm re-establishment, while postoperative parameters have high prognostic value. Using ROC curve analysis, we provide cut-off thresholds with predictive value: postoperative left atrial diameter < 42.5 mm (AUC = 0.798, sensitivity 75%, specificity) 63.8%, p=0.05), LA diameter at 6 months follow-up < 45.5 mm (AUC = 0.929, sensitivity 75%, specificity 88.6%, p < 0.01), left atrial volume index (LAVi) re-examination at 6 months <62 ml/m2 (AUC = 0.827, sensitivity 75%, specificity 84.6%, p<0.05), LAVi re-examination at 6 months <60.5 ml/m2 (AUC = 0.867, sensitivity 67%, specificity 91.4%, p<0.05) increased the success rate of sinus cardioversion. Conclusion: Maze surgery has a high success rate in patients who are indicated for mitral valve replacement surgery. Using ROC curve analysis, the parameters on echocardiography at 6 months after surgery: LA diameter < 45.5 mm, LAVi < 60.5 ml/m2 are factors that increase the success rate of ablation of atrial fibrillation and sinus cardioversion.