Abstract
Objectives- Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. Drug treatment of AF usually leads to unsatisfactory rate of recurrence. The Cox-maze III procedure for atrial fibrillation has been offered effective in restoring sinus rhythm in patients with mitral valve disease.
Methods- This research is a cross sectional and descriptive study from 2002 to 2004. 10 consecutive patients with rheumatic mitral valve disease and chronic AF underwent Cox-maze III procedure concomitantly to mitral valve replacement. Associated procedures were tricuspid valve repair in 4 patients and Aortic valve replacement in 2 patients. Our indications to perform Maze-III Procedure were chronic AF, medical history of previous thromboembolic events and large left atrium on preoperative transthoracic echocardiography
Results- There were 2 men and 8 women with a mean age of 40±8 years. Mean aortic cross-clamp and cardiopulmonary bypass times were 90±11 and 144 ± 18 minutes respectively. There was no in hospital mortality. Normal sinus rhythm was restored early post operative in 60% and late in 80% of patients. Right atrial and left atrial contractility was found in 80% and 70% of the patients in trans esophageal echocardiography 6 month postoperation.
Conclusions- The maze III procedure associated with mitral valve replacement is a safe and effective surgical technique for conversion of AF to sinus rhythm and restore atrial contractility in rheumatic heart disease.