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Mei Mini Maze Procedure:Five Years’ Experience of Consecutive 353 Patients in Single Center
Ju Mei, Nan Ma, Zhaolei Jiang, Hao Liu, Jiaquan Zhu.
Department of Cardiothoracic Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
OBJECTIVE: Mei mini maze procedure was a new thoracoscopic ablation procedure for atrial fibrillation (AF), which was performed on the beating heart through 3 ports in the left chest wall. Here, we reported the five years’ experience of Mei mini maze procedure for AF.
METHODS: Between June 2010 and May 2015,353 patients (240 males, 59.7±8.5 years) of AF (paroxysmal 186, non-paroxysmal 167) received this therapy. The procedure was performed through 3 ports (10 mm, 10 mm, 25 mm) on left chest wall, included pulmonary vein isolation and ablations of the roof and posterior wall of left atrium which were achieved by bipolar radiofrequency ablation. Ganglionic plexus ablation was made by the ablation pen. Left atrial appendage was excluded with surgical stapler. 24-hour holter monitoring was performed at discharge and 3, 6, 12 months postoperatively as well as every year thereafter.
RESULTS: The procedure was performed successfully for all patients. Average duration of procedure was 92.3±19.1 minutes. No conversion to sternotomy or thoracotomy. There was no early death and permanent pacemaker implantation in perioperation. Mean hospital stay was 8.5 ±2.1 days. The maintenance of sinus rhythm was 94.1% (332/353) at discharge. At a mean follow-up of 25.0±15.1 months, full follow-up was available for 342 (97.2%) patients. There was no late death. 308 of 342 (90.1%) patients were in sinus rhythm. The maintenance of sinus rhythm was 93.3% (168/180) for paroxysmal AF, 87.9% (80/91) for persistent AF, 84.5% (60/71) for long-standing persistent AF. The rate of cumulative maintenance of sinus rhythm at 2 years postoperatively was 92.4±2.4% for paroxysmal AF, which was significant higher than that of persistent AF (86.2±4.4%, P=0.036) or long-standing persistent AF (81.8±5.4%, P=0.014). There was no significant difference of cumulative maintenance of sinus rhythm between persistent AF and long-standing persistent AF (P=0.645). Stroke, thrombus in the left atrium and stenosis of pulmonary vein were not found after their procedures.
CONCLUSIONS: Our results demonstrate that Mei mini maze procedure is a safe, effective, and appropriate treatment for AF, which may be also associated with the prevention of AF-related stroke.
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