Mid-term Results of Minimally Invasive Mitral Valve Surgery with Concomitant Maze Iv Procedure
Pan Dan, Dengwei CAO, Li ZHANG, Jinping ZHAO, Jinping LIU
Department of cardiac surgery, Zhongnan hospital of Wuhan University, Wuhan, China
BACKGROUND: Novel surgical ablation techniques for atrial fibrillation facilitate concurrent minimally invasive procedures. This study describes our mid-term results of mitral valve surgery with concomitant Maze IV procedure through a right-sided minithoracotomy approach.METHODS: Retrospective data from July 2016 to September 2020 were collected from 68 patients who underwent a minimally invasive mitral valve surgery with a concomitant Maze IV procedure, and associated with left atrial appendage closure. RESULTS: In our group of patients, the mean age was 55.6 years, 26 patients were male. The mean STS score was 3.4%. The etiology of mitral valve disease was rheumatic for 56 patients and degenerative for 12 patients. All patients had long-standing persistent atrial fibrillation. Mitral surgery included mitral valve repair in 17.6 % of patients and mitral valve replacement in 82.4 % of patients. The in-hospital mortality was null. major complications included myocardial infarction, stroke, or transient ischemic attack and permanent pacemaker implantation was all null. The mean hospital stay was 26.8 days. At the time of discharge, 2 patients showed mild residual mitral regurgitation. Eighty-six percent of patients were free from atrial arrhythmia at discharge. After a mean follow-up of 38 months, all patients were alive, no regurgitation progression or deterioration in prosthetic function was observed from their last echocardiography. Fifty-five patients (80.9%) were in a stable sinus rhythm and 13 patients (19.1%) were in atrial fibrillation. Patients received antiarrhythmic medication in 20.6% of cases.CONCLUSIONS:Mitral valve surgery with concomitant Maze IV procedure can be successfully performed through minimally invasive approach with satisfying mid-term results.