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同期改良迷宫手术与二尖瓣手术的长期疗效

Long-Term Outcomes of Concomitant Modified Cox-Maze and Mitral Surgery.

作者信息

Kasemsarn Choosak, Porapakkham Pramote, Wathanawanichakun Sahaporn, Lerdsomboon Piyawat, Chanpa Krisulang

机构信息

Department of Cardiothoracic Surgery, Central Chest Institute of Thailand, Nonthaburi, Thailand.

出版信息

Ann Thorac Cardiovasc Surg. 2025;31(1). doi: 10.5761/atcs.oa.24-00119.

DOI:10.5761/atcs.oa.24-00119
PMID:40128947
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11931737/
Abstract

PURPOSE

There are limited data on outcomes of combined Maze and mitral valve procedures beyond 10 years. This study analyzed the efficacy of this operation.

METHODS

Between June 2004 and December 2022, 406 patients underwent mitral surgery concomitant with Maze procedure were evaluated. Rhythm outcomes, predictors of recurrence, and survival were assessed.

RESULTS

The median follow-up period was 100 months. Rheumatic disease was present in 58%. Mitral valve repair was performed in 57.1%. Freedom from atrial fibrillation (AF) at 5, 10, and 15 years was 82.5%, 70.8%, and 52.7%, respectively. Overall survival rates were not different between patients in sinus rhythm (SR) and those who remained in AF (p = 0.172). However, patients in SR experienced fewer neurological complication (p = 0.001). Predictors of AF recurrence included preoperative AF duration (p = 0.005), left atrial diameter (LAD) >50 mm (p <0.001), concomitant tricuspid valve surgery (p = 0.049), and the presence of AF on postoperative day 7 (p <0.001). Factors influencing survival were age >60 years (p <0.001) and a postoperative left ventricular ejection fraction <40% (p <0.001).

CONCLUSIONS

The combined Maze and mitral valve surgery provides significant benefits in managing AF with mitral disease. Predictors of recurrence included AF duration, LAD size >50 mm, associated tricuspid valve disease, and AF on day 7. SR patients had fewer neurological complications.

摘要

目的

关于迷宫手术与二尖瓣手术联合治疗超过10年的结果数据有限。本研究分析了该手术的疗效。

方法

在2004年6月至2022年12月期间，对406例行二尖瓣手术并同期行迷宫手术的患者进行了评估。评估了心律结果、复发预测因素和生存率。

结果

中位随访期为100个月。58%的患者患有风湿性疾病。57.1%的患者进行了二尖瓣修复。5年、10年和15年时无房颤（AF）的发生率分别为82.5%、70.8%和52.7%。窦性心律（SR）患者和仍处于房颤状态的患者的总生存率无差异（p = 0.172）。然而，SR患者的神经系统并发症较少（p = 0.001）。房颤复发的预测因素包括术前房颤持续时间（p = 0.005）、左心房直径（LAD）>50 mm（p <0.001）、同期三尖瓣手术（p = 0.049）以及术后第7天存在房颤（p <0.001）。影响生存的因素包括年龄>60岁（p <0.001）和术后左心室射血分数<40%（p <0.001）。

结论

迷宫手术与二尖瓣手术联合治疗在二尖瓣疾病合并房颤的管理中具有显著益处。复发的预测因素包括房颤持续时间、LAD大小>50 mm、相关三尖瓣疾病以及术后第7天的房颤。SR患者的神经系统并发症较少。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/528dc2341178/atcs-31-1-24-00119-figure09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/93859339ef4b/atcs-31-1-24-00119-figure01.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/07b930120eb5/atcs-31-1-24-00119-figure08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/528dc2341178/atcs-31-1-24-00119-figure09.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/93859339ef4b/atcs-31-1-24-00119-figure01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/b48efc855300/atcs-31-1-24-00119-figure02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/d11e16f558df/atcs-31-1-24-00119-figure03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/dc41a0957c1c/atcs-31-1-24-00119-figure04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/7b5d0d2be587/atcs-31-1-24-00119-figure05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/72692a0b982a/atcs-31-1-24-00119-figure06.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/2eb9e1f451a5/atcs-31-1-24-00119-figure07.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/07b930120eb5/atcs-31-1-24-00119-figure08.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e013/11931737/528dc2341178/atcs-31-1-24-00119-figure09.jpg

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本文引用的文献

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Front Cardiovasc Med. 2023 Mar 10;10:1091312. doi: 10.3389/fcvm.2023.1091312. eCollection 2023.
2
A new surgical technique for left atrial reduction in giant left atrium.一种用于巨大左心房左心房缩小的新手术技术。
JTCVS Tech. 2022 Nov 3;17:56-64. doi: 10.1016/j.xjtc.2022.10.013. eCollection 2023 Feb.
3
Long Atrial Fibrillation Duration and Early Recurrence Are Reliable Predictors of Late Recurrence After Radiofrequency Catheter Ablation.
房颤持续时间长和早期复发是射频导管消融术后晚期复发的可靠预测因素。
Front Cardiovasc Med. 2022 Mar 25;9:864417. doi: 10.3389/fcvm.2022.864417. eCollection 2022.
4
Surgical Atrial Fibrillation Ablation With and Without Left Atrium Reduction for Patients Scheduled for Mitral Valve Surgery: A Prospective Randomised Study.接受二尖瓣手术的患者行或不行左心房缩小的房颤外科消融术：一项前瞻性随机研究。
Heart Lung Circ. 2021 Jun;30(6):922-931. doi: 10.1016/j.hlc.2020.10.027. Epub 2020 Dec 11.
5
Epidemiology of Atrial Fibrillation in the 21st Century: Novel Methods and New Insights.21 世纪心房颤动的流行病学：新方法与新见解。
Circ Res. 2020 Jun 19;127(1):4-20. doi: 10.1161/CIRCRESAHA.120.316340. Epub 2020 Jun 18.
6
The long-term outcomes and durability of the Cox-Maze IV procedure for atrial fibrillation.Cox-Maze IV 手术治疗心房颤动的长期疗效和持久性。
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