Surgical outcomes of modified-maze procedures in adults with atrial septal defect

Surg Today. 2019 Feb;49(2):124-129. doi: 10.1007/s00595-018-1709-9. Epub 2018 Sep 3.

Abstract

Purpose: We examined the outcome of modified-maze procedures reflecting a single-center strategy in the treatment of atrial fibrillation (AF) associated with atrial septal defect (ASD) in adults.

Methods: A retrospective chart review was performed for 29 patients who underwent surgical ASD closure and 2 types of maze procedures (full and simplified maze procedures) for AF. The outcome related to the each procedure was examined. A Cox proportional hazards analysis was performed to assess the independent predictors of AF and atrial tachycardia (AT) recurrence.

Results: The rates of freedom from AF and AT recurrence at 1 and 4 years were 86.6% and 72.2% in the full maze group and 78.5% and 62.8% in the simplified maze group, respectively (p = 0.70). The only risk factor for recurrence was the age at the time of surgery. A receiver operating characteristic curve analysis gave an optimum cut-off value of 58 years of age for predicting recurrence within 2 years (58.4% for ≥ 58 years versus 5.9% for < 58 years, p = 0.003).

Conclusions: Simplification of the maze procedure was not associated with AF or AT recurrence. The age at the time of surgery might be a clinical predictor of success or failure in adult patients.

Keywords: Atrial septal defect; Maze procedure; Radiofrequency ablation.

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Atrial Fibrillation / etiology*
  • Atrial Fibrillation / surgery*
  • Cardiac Surgical Procedures / methods*
  • Female
  • Heart Septal Defects, Atrial / complications*
  • Heart Septal Defects, Atrial / surgery*
  • Humans
  • Male
  • Middle Aged
  • Proportional Hazards Models
  • ROC Curve
  • Radiofrequency Ablation
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome