نتايج جراحي فيبريلاسيون دهليزي COX MAZE III همراه با جراحي دريچه ميترال در ده بيمار در مركز قلب شهيد مدني

Results of Atrial Fibrillation Surgery (Cox Maze III) with Mitral Valve in 10 Patients in Shahid Madani Heart Hospital

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 111 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-Ill 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 rhy thm and restore atrial contractility in rheumatic heart disease.