The aim of this study is to evaluate the influence of the Maze Procedure in the treatment of rheumatic atrial fibrillation (AF) in patients with mitral valve disease (MVD). Between July 91 and June 94, 55 patients with rheumatic MVD (35 double dysfunction and 19 stenosis) and associated AF were operated on. The mean age was 51 yrs and 47 were female. All pts were in FC (NYHA) III or IV pre operatively. The patients were divided in 2 groups, according to the type of operation: GI - 20 patients submitted to MVD treatment and Maze Procedure and GII - 35 patients submitted only to MVD treatment. Pre-operative Echo showed left atrial diameter in G I and GII of 5,35 mm and 5.57 mm (p = 0.779). Mitral valve was replaced by biological prosthesis in 24 patients and conserved in 31 patients. Three hospital deaths were observed, with one in GI. After CPB, 37.1% of patients in GII remained in AF, and all patients in GI recovered regular rhythm (p < 0.0001). In the ICU, AF was detected in 82.4% in GII and maintained in 76.4% in a mean follow-up time of 38.5 months. In GI, AF was observed in 21.1% of pts in ICU and maintained in 5.2% in 41 months of follow-up (p = 0.0001). None of the pts in GI and 20.6% of pts in GII presented thromboembolic episode, 1 to 63 months after operation (p = 0.041). Four late deaths were observed (2 in each group), being 2 due to progression of valvular disease, 1 after a pulmonary infection episode and 1 with no cardiac cause. Maze Procedure was effective in treating AF in rheumatic MVD, maintaining the results in a late follow-up, preventing postoperative thromboembolic episodes and with acceptable morbidity and mortality.
Atrial fibrillation; Cardiac surgical procedures; Heart valve diseases; Rheumatic heart diseases; Mitral valve; Atrial fibrillation; Heart valve diseases; Rheumatic heart diseases; Atrial fibrillation
