초록접수 현황
| 16F-113 | 구연 발표 |
Long-term Result of Concomitant Maze Procedure during Mitral Valve Surgery in Patients with a Giant Left Atrium: The Effect of Left Atrial Volume Resection
Jae Hyun Kim¹, Woo Sung Jang¹, Jae Bum Kim¹, Sook Jin Lee²
¹Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea, ²Department of Cardiology, Sejong General Hospital, Gyeonggi-do, Korea
Background : An enlarged left atrium is a risk factor for failure of a maze procedure. Whether to perform concomitant maze procedure during mitral valve surgery in patients with a giant left atrium is a dilemma to surgeons. We analyzed the long-term result of concomitant maze procedure in patients with a giant left atrium and evaluated the effect of left atrial volume resection.
Methods : Between 2000 and 2011, 134 patients with a giant LA (antero-posterior dimension ≥ 70mm) who underwent the maze procedure during mitral valve surgery, were retrospectively reviewed. The average length of follow-up was 65 months. For the subgroup analysis, LA resection group (group I, n = 46) and non-resection group (group II, n = 88) were compared.
Results : Cardiac ischemic time and cardio-pulmonary bypass time were longer in group I (176 and 227 minutes , respectively) than group II (144 and 201 minutes, resepectively) (P < 0.001 and 0.029, respectively). With respect to in-hospital mortality and morbidity, there was no difference between the two groups. In group I, the rate of sinus rhythm restoration was 86.8%, 81.2% and 53.2% at 6 month, 1 and 3 year, respectively, compared with 55.9%, 49.0% and 33.2%, respectively in group II (p = 0.006). LA dimension was more significantly reduced to 54mm in group I comparing with 64mm in group II (p < 0.001). LA volume reduction was more significant in group I (60% reduction) than in group II (29% reduction) (p < 0.001). Multivariate analysis revealed LA non-resection as only risk factor for the failure of a maze procedure.
Conclusion : In patients with a giant LA, maze procedure itself was not sufficient to guarantee the sinus rhythm restoration. Aggressive LA volume reductions are needed to raise up the success rates of maze procedure in patients with a giant LA.
Methods : Between 2000 and 2011, 134 patients with a giant LA (antero-posterior dimension ≥ 70mm) who underwent the maze procedure during mitral valve surgery, were retrospectively reviewed. The average length of follow-up was 65 months. For the subgroup analysis, LA resection group (group I, n = 46) and non-resection group (group II, n = 88) were compared.
Results : Cardiac ischemic time and cardio-pulmonary bypass time were longer in group I (176 and 227 minutes , respectively) than group II (144 and 201 minutes, resepectively) (P < 0.001 and 0.029, respectively). With respect to in-hospital mortality and morbidity, there was no difference between the two groups. In group I, the rate of sinus rhythm restoration was 86.8%, 81.2% and 53.2% at 6 month, 1 and 3 year, respectively, compared with 55.9%, 49.0% and 33.2%, respectively in group II (p = 0.006). LA dimension was more significantly reduced to 54mm in group I comparing with 64mm in group II (p < 0.001). LA volume reduction was more significant in group I (60% reduction) than in group II (29% reduction) (p < 0.001). Multivariate analysis revealed LA non-resection as only risk factor for the failure of a maze procedure.
Conclusion : In patients with a giant LA, maze procedure itself was not sufficient to guarantee the sinus rhythm restoration. Aggressive LA volume reductions are needed to raise up the success rates of maze procedure in patients with a giant LA.
책임저자: Jae Hyun Kim
Department of Thoracic and Cardiovascular Surgery, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea
발표자: Jae Hyun Kim, E-mail : jaemax31@gmail.com