Wang Chang-Tian, Zhang Lei, Qin Tao, Xi Zhi-Long, Sun Lei, Wu Hai-Wei, Li De-Min
Department of Cardiovascular Surgery. Jinling Hospital, Nanjing University, School Medicine, 305 East Zhongshan Road, Nanjing, 210002, PR China.
J Cardiothorac Surg. 2020 May 24;15(1):111. doi: 10.1186/s13019-020-01165-4.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in patients with heart valve disease. Our aim was to summarize our experience and evaluate the efficacy and safety of the Cox maze III procedure combined with valve surgery in patients with AF.
A retrospective, observational analysis was performed for all consecutive patients underwent maze III procedure combined with valve surgery between October 2015 and June 2019. In this trial, we used a monopolar radiofrequency (RF) ablation in addition to cut and sew technique to treat AF.
66 patients (37 female, 56.1%) with persistent or long-lasting persistent AF associated with valve disease were identified. The mean age was 54.2 ± 8.4 years (range, 30 to 73 years). Overall hospital mortality was 3.0%. The duration of cardiopulmonary bypass and aortic cross clamping was 175.4 ± 32.9 and 115.6 ± 22.8 min respectively. The first 24 h drainage was 488.6 ± 293.3 ml. The postoperative hospital stay was 14.8 ± 8.3 days. The postoperative incidence of permanent pacemaker implantation, reoperation for bleeding, renal failure required hemodialysis, and stroke was 4.5, 1.5, 4.5% and 0 respectively. The frequency of sinus rhythm was 91.7, 93.1, 94.7, 93.3 and 89.5% at 1, 3, 6, 12, and 24 months respectively.
The Cox-Maze III procedure is safe in the surgical treatment of AF associated with valve disease, and efficacious for sinus rhythm maintenance, with low morbidity and mortality.
心房颤动（AF）是心脏瓣膜病患者中最常见的持续性心律失常。我们的目的是总结我们的经验，并评估Cox迷宫III手术联合瓣膜手术治疗AF患者的疗效和安全性。
对2015年10月至2019年6月期间连续接受迷宫III手术联合瓣膜手术的所有患者进行回顾性观察分析。在本试验中，除了切割缝合技术外，我们还使用单极射频（RF）消融术治疗AF。
共确定了66例（37例女性，占56.1%）患有与瓣膜病相关的持续性或长期持续性AF的患者。平均年龄为54.2±8.4岁（范围为30至73岁）。总体医院死亡率为3.0%。体外循环和主动脉阻断时间分别为175.4±32.9分钟和115.6±22.8分钟。术后24小时引流量为488.6±293.3毫升。术后住院时间为14.8±8.3天。永久起搏器植入、再次手术止血、需要血液透析的肾衰竭和中风的术后发生率分别为4.5%、1.5%、4.5%和0。窦性心律的频率在1、3、6、12和24个月时分别为91.7%、93.1%、94.7%、93.3%和89.5%。
Cox迷宫III手术在治疗与瓣膜病相关的AF时是安全的，对于维持窦性心律有效，发病率和死亡率低。
