초록접수 현황
| 14F-129 | 구연 발표 |
Results of the Concomitant Cox-maze Procedure in Patients Over 70 Years Old
최종범, 김종헌, 차병기, 김경화, 이정문, 구자홍
전북대학교 의학전문대학원 흉부외과학교실
Background : Elderly patients with chronic atrial fibrillation (AF) present a special challenge. Despite the documented advantage in ablating AF, the addition of the procedure may add surgical complexity and potentially impact surgical outcome. However, the AF surgery is more important in the elderly because they have more chance of embolic complications from the AF. This study explored the impact of the Cox-Maze III procedure on the elderly patients experiencing AF who present for cardiac surgery.
Methods : Twenty-one patients aged ≥ 70 (mean age, 72.7 ± 2.3; female, 71.4%) with concomitant cardiac surgery underwent the Cox-Maze procedure for AF. Biatrial procedure was performed in the same strategic method using a bipolar radiofrequency electrode and a cryoablator together. Except for the Cox-Maze procedure, 90.5% (19/21) of the patients underwent two or more major procedures.
Results : The mean age of the survived patients at the end-point of the study was 76.6 ± 2.3 years. The patients formed 20% (21/105) of our patients who underwent the Cox-Maze procedure. Most patients with the Cox-maze procedure underwent concomitant valve surgery (n= 20, 95.2%). At a mean follow-up period of 45.1 ± 9.1 months, 90% (18/20) of patients had sinus rhythm without sinus-converting medication (amiodarone, etc). There were no embolic strokes. Six-year survival was 95.6 ±4.6% and 6-yr freedom from AF was 90.0 ± 6.7%. There was one operative mortality in this group (4.8%).
Conclusion : Addiction of the Cox-Maze procedure in patients ≥ 70 years may add to the complexity of the surgical procedure, but the procedure can be performed without a significant operative risk. Age may not be the only discriminating factor when considering the AF surgery for patients aged ≥ 70 years who present for cardiac surgery while experiencing AF.
Methods : Twenty-one patients aged ≥ 70 (mean age, 72.7 ± 2.3; female, 71.4%) with concomitant cardiac surgery underwent the Cox-Maze procedure for AF. Biatrial procedure was performed in the same strategic method using a bipolar radiofrequency electrode and a cryoablator together. Except for the Cox-Maze procedure, 90.5% (19/21) of the patients underwent two or more major procedures.
Results : The mean age of the survived patients at the end-point of the study was 76.6 ± 2.3 years. The patients formed 20% (21/105) of our patients who underwent the Cox-Maze procedure. Most patients with the Cox-maze procedure underwent concomitant valve surgery (n= 20, 95.2%). At a mean follow-up period of 45.1 ± 9.1 months, 90% (18/20) of patients had sinus rhythm without sinus-converting medication (amiodarone, etc). There were no embolic strokes. Six-year survival was 95.6 ±4.6% and 6-yr freedom from AF was 90.0 ± 6.7%. There was one operative mortality in this group (4.8%).
Conclusion : Addiction of the Cox-Maze procedure in patients ≥ 70 years may add to the complexity of the surgical procedure, but the procedure can be performed without a significant operative risk. Age may not be the only discriminating factor when considering the AF surgery for patients aged ≥ 70 years who present for cardiac surgery while experiencing AF.
책임저자: 최종범
전북대학교 의학전문대학원 흉부외과학교실
연락처 : 최종범, Tel: 063-250-1486 , E-mail : jobchoi@jbnu.ac.kr
