The Maze procedure significantly decreased left atrial ejection fraction compared to matched normal controls (14.9% vs 47.9%, p<0.001) at one month post-surgery, with no improvement at six months.
Observational (n=24)
Randomized for secondary analysis
No
Does the Maze procedure restore normal left atrial contractile function in patients with valvular AF undergoing mitral valve surgery?
Contractile function of the left atrium remains significantly impaired after successful sinus rhythm conversion by the Maze procedure in patients with valvular AF compared to normal controls.
Absolute Event Rate: 14.9% vs 47.9%
p-value: p=<0.001
PURPOSE: The Maze procedure has shown excellent efficacy in the elimination of atrial fibrillation (AF); however, little is known about the quality of functional recovery in the left atrium (LA) following successful sinus rhythm conversion by the Maze procedure. MATERIALS AND METHODS: We prospectively enrolled 12 patients (aged 52.5±10.1 years, 1 female) with valvular AF undergoing mitral valve surgery combined with the Maze procedure. Parameters of LA function in three anatomic compartments anterior, posterior, and LA appendage (LAA) were evaluated using electrocardiography-gated dual-source cardiac CT at one month and at six months after surgery. Twelve subjects matched by age, gender, and body surface area served as controls. RESULTS: At one month after surgery, ejection fraction (EF) and emptying volume (EV) of the LA were 14.9±7.4% and 21.3±9.7 mL, respectively, and they were significantly lower than those of the control group (EF, 47.9±11.2%; EV, 46.0±10.7%; p<0001). These values did not significantly change throughout late periods (p=0.22 and 0.21, respectively). Functional contributions of the anterior, posterior, and appendage compartments (EV of each compartment/overall EV) were 80.4%, -0.9%, and 20.5%, respectively, for those with LAA preservation (n=6); 100.1%, -0.1%, and 0% for those with LAA resection (n=6; p<0.05); and 62.2%, 28.2%, and 9.7% in the control subjects (p<0.001). CONCLUSION: Contractile functions of the LA significantly decreased after the Maze procedure. Functional contributions of three compartments of the LA were also altered. The influence of LAA preservation on postoperative LA functions needs to be evaluated through studies of larger populations.
Kim et al. (Thu,) conducted a observational in Valvular atrial fibrillation (n=24). Maze procedure vs. Matched normal controls was evaluated on Left atrial ejection fraction at 1 month (p=<0.001). The Maze procedure significantly decreased left atrial ejection fraction compared to matched normal controls (14.9% vs 47.9%, p<0.001) at one month post-surgery, with no improvement at six months.