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J Thorac Cardiovasc Surg 2006;132:1433-1440
© 2006 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

Freedom from atrial arrhythmias after classic maze III surgery: A 10-year experience

^a Heart Lung Center Utrecht, Department of Cardiothoracic Surgery, St Antonius Hospital, Nieuwegein, The Netherlands
^b Heart Lung Center Utrecht, Department of Cardiology, St Antonius Hospital, Nieuwegein, The Netherlands.

^_* Address for reprints: Philippe K. E. W. Ballaux, MD, Department of Cardiac Surgery, Maria Middelares Hospital, Kortijksesteenweg 1026, B-9000 Gent, Belgium. (Email: phballaux{at}yahoo.com).

OBJECTIVES: We studied the persistence of favorable outcome, the occurrence of new atrial arrhythmias, and sinus node dysfunction in patients who underwent the maze III procedure.

METHODS: Preoperative, in-hospital, and follow-up data of 203 patients who underwent the maze III procedure between June 1993 and June 2003 were collected. A total of 139 patients underwent the maze procedure for lone atrial fibrillation, and 64 patients underwent the maze procedure and concomitant cardiac surgery.

RESULTS: There was no 30-day postoperative mortality. During a mean follow-up of 4.0 ± 2.6 years, 12 patients (6%) died (2 cardiac related). At the end of follow-up, freedom from supraventricular arrhythmias was 80% for the lone atrial fibrillation group and 64% for the concomitant atrial fibrillation group. Freedom from stroke during follow-up was 100% in the lone atrial fibrillation group and 97% in the concomitant group. Multivariate analysis revealed that rhythm at 1-year follow-up (P < .001; odds ratio 9.56, 95% confidence limits 3.92-23.31) and preoperative left atrium dimension (P = .028; odds ratio 1.06 for every millimeter, 95% confidence limits 1.01-1.12) were predictors of success at the end of follow-up.

CONCLUSIONS: This study shows that the favorable results of the maze III procedure in terms of freedom from supraventricular arrhythmias persist in most patients for at least 4 years.

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