초록접수 현황
| 17F-227 | 구연 미채택시 포럼 발표 |
Long-term Outcome of Maze Procedure Combined with Endoatriectomy Performed in Calcified Left Atrium
Yochun Jung, Gwan Sic Kim, Kyo Seon Lee, In Seok Jeong, Sang Gi Oh, Kook Joo Na, Byoung Hee Ahn
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
Purpose : Left atrium (LA) covered with organized or calcified peel is often considered as a contraindication of Maze procedure for expectation of electrophysiologically poor outcome and technical difficulty. In such cases, we have performed endoatriectomy followed by Maze procedure. We aimed to validate the technical feasibility and long term outcome of it.
Methods : Between January 2004 and December 2016, Maze procedure combined with endoatriectomy was performed in 18 patients (7 males; median 57 years). Preoperative atrial fibrillation (AF) was long-standing persistent type in all patients. Six patients had a history of suffering from stroke. Medical records were reviewed retrospectively.
Results : There were two troublesome intraoperative bleeding from LA auricle, necessitating cardiopulmonary bypass rerunning. One operative death occurred from sepsis following mediastintis. Permanent pacemaker (PPM) was implanted for sick sinus syndrome (SSS) in one patient at postoperative day 21. Median follow-up duration for 17 survivors was 9.1 years. There were 3 late mortalities but no thromboembolic event. In 2 patients, PPMs were implanted for SSS in postoperative 9.0 and 12.2 years, respectively. AF recurred in 10 patients in median 13.7 months postoperatively. At last follow-up, 7 patients was in normal sinus rhythm without antiarrhythmic drug, 3 in junctional rhythm, and 8 in AF. AF recurrence-free survival at postoperative 1, 5, 10 year was 70%, 45%, and 36%, respectively.
Conclusion : Maze procedure combined with endoatriectomy in calcified LA was technically feasible and beneficial in about a half of patients. Calcified LA itself should not be regarded as a contraindication of Maze procedure.
Methods : Between January 2004 and December 2016, Maze procedure combined with endoatriectomy was performed in 18 patients (7 males; median 57 years). Preoperative atrial fibrillation (AF) was long-standing persistent type in all patients. Six patients had a history of suffering from stroke. Medical records were reviewed retrospectively.
Results : There were two troublesome intraoperative bleeding from LA auricle, necessitating cardiopulmonary bypass rerunning. One operative death occurred from sepsis following mediastintis. Permanent pacemaker (PPM) was implanted for sick sinus syndrome (SSS) in one patient at postoperative day 21. Median follow-up duration for 17 survivors was 9.1 years. There were 3 late mortalities but no thromboembolic event. In 2 patients, PPMs were implanted for SSS in postoperative 9.0 and 12.2 years, respectively. AF recurred in 10 patients in median 13.7 months postoperatively. At last follow-up, 7 patients was in normal sinus rhythm without antiarrhythmic drug, 3 in junctional rhythm, and 8 in AF. AF recurrence-free survival at postoperative 1, 5, 10 year was 70%, 45%, and 36%, respectively.
Conclusion : Maze procedure combined with endoatriectomy in calcified LA was technically feasible and beneficial in about a half of patients. Calcified LA itself should not be regarded as a contraindication of Maze procedure.
책임저자: Yochun Jung
Department of Thoracic and Cardiovascular Surgery, Chonnam National University Hospital, Chonnam National University College of Medicine, Gwangju, Republic of Korea
발표자: Yochun Jung, E-mail : yochuni@naver.com