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Revista Brasileira de Cirurgia Cardiovascular
On-line version ISSN 1678-9741
KALIL, Renato A. K. et al. Comparative results of maze procedure for chronic atrial fibrillation in rheumatic and degenerative mitral valve disease. Rev Bras Cir Cardiovasc [online]. 1999, vol.14, n.3, pp. 191-199. ISSN 1678-9741. http://dx.doi.org/10.1590/S0102-76381999000300003.
The results of maze procedure in rheumatic mitral valve disease are subject to debate. This paper reports medium term results in rheumatic and degenerative mitral valve surgery associated with maze procedure. From 1994 to 1997, 57 patients were operated on. They were divided into two Groups; R (rheumatic) 40 patients and D (degenerative) 17. Group R included 8 (20%) males and 32 (80%) females. Group D: 8 (47%) males and 9 (53%) females (NS). Age in R = 47 ± 11 and D 54 ± 17 years (p < 0.05). Left atrial size was 6.1 ± 1.1 cm in R and 5.9 ± 1.2 in D (NS). There were 3 hospital deaths, 1 (2.5%) in R and 2 (12%) in D. One D patient (7%) died late. Pacemakers were implanted in 4 (10%) R and 2 (17%) in D (NS). There were no significant differences regarding surgical duration of perfusion or myocardial ischemia, antiarrhythmic medications, immediate or late cardiac rythms and occurrence of arrythmias. Ergometric evaluation for measuring chronotropic response revealed a normal response in 6 (25%) R and 1 (10%) in D at a mean of 16.6 months PO. In the lower response group, 3 (12.5%) R and 6 (60%) D had intermediate values (p = 0.009) and 15 (62.5%) R versus 3 (30%) D had values below 75% of expected heart rate (p = 0.09). Rheumatic or degenerative ethiology of mitral valve disease does not influence the results of maze procedure in this patient population. Mean chronotropic response to exercise tends to be lower in degenerative patients.
Keywords : Mitral valve [surgery]; Atrial fibrillation [surgery]; Arrhythmia, sinus [surgery]; Rheumatic heart disease.