Modified radial v/s biatrial maze for atrial fibrillation in rheumatic valvular heart surgery

Sayed, Sajid; Katewa, Ashish; Srivastava, Vivek; Jana, Sujit; Patwardhan, Anil

doi:10.1016/j.ihj.2014.05.010

Cited by 3 publications

(5 citation statements)

References 27 publications

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“…On the contrary, Yuda and colleagues [ 28 ] demonstrated that once AC was resumed, its degree did not change during follow-up: the difference with respect to our results may lie in the major prevalence in their sample of mitral valve replacement (prosthesis could modify modality of LA transport function) and of basal LV dysfunction associated with a more aggressive lesions set performed with mixed cut and sew technique and cryoenergy. A recent report from Sayed et al [ 29 ] highlighted the fact that the “left side only” ablation procedure, when compared to biatrial one, allowed better 6-month A/E ratio but with a mean value largely lower (0.52) than the one emerging from our trial. Nevertheless, again, enrolled patients were all affected by rheumatic disease, thus perhaps explaining worse postoperative atrial function.…”

Section: Discussionmentioning

confidence: 48%

Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

Loardi

Alamanni

Galli

et al. 2015

BioMed Research International

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Background. Maze procedure aims at restoring sinus rhythm (SR) and atrial contractility (AC). This study evaluated multiple aspects of AC recovery and their relationship with SR regain after ablation. Methods. 122 mitral and fibrillating patients underwent radiofrequency Maze. Rhythm check and echocardiographic control of biatrial contractility were performed at 3, 6, 12, and 24 months postoperatively. A multivariate Cox analysis of risk factors for absence of AC recuperation was applied. Results. At 2-years follow-up, SR was achieved in 79% of patients. SR-AC coexistence increased from 76% until 98%, while biatrial contraction detection augmented from 84 to 98% at late stage. Shorter preoperative arrhythmia duration was the only common predictor of SR-AC restoring, while pulmonary artery pressure (PAP) negatively influenced AC recuperation. Early AC restoration favored future freedom from arrhythmia recurrence. Minor LA dimensions correlated with improved future A/E value and vice versa. Right atrial (RA) contractility restoring favored better left ventricular (LV) performance and volumes. Conclusions. SR and left AC are two interrelated Maze objectives. Factors associated with arrhythmia “chronic state” (PAP and arrhythmia duration) are negative predictors of procedural success. Our results suggest an association between postoperative LA dimensions and “kick” restoring and an influence of RA contraction onto LV function.

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Section: Discussionmentioning

confidence: 48%

Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

Loardi

Alamanni

Galli

et al. 2015

BioMed Research International

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“…We previously described the case of a patient who had atrial fibrillation before surgery and needed modified maze surgery [ 16 ]. In the preoperative evaluation of patients with HOCM, it is necessary not only to evaluate the extent of resection but also to understand the shape of the nerve tracts in patients with HOCM.…”

Section: Discussionmentioning

confidence: 99%

Effect of 3D-printed hearts used in left ventricular outflow tract obstruction: a multicenter study

Wang

Liang

et al. 2022

BMC Cardiovasc Disord

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Objective The purpose of this research was to explore the application value of a three-dimensional (3D)-printed heart in surgery for left ventricular outflow tract (LVOT) obstruction. Methods From August 2019 to October 2021, 46 patients with LVOT obstruction underwent surgical treatment at our institution. According to the treatment method, 22 and 24 patients were allocated to the experimental and control groups, respectively. In the experimental group, each patient’s 3D-printed heart model was used for simulated preoperative surgery, and then the Morrow operation was performed. In the control group, only the Morrow operation was performed, without simulated preoperative surgery using a 3D-printed heart model. The intraoperative and postoperative data of patients in the two groups were recorded, and the clinical data of patients were compared between the two groups. Results The operation time, cardiopulmonary bypass time, intraoperative blood loss, hospitalization time, LVOT pressure difference (LVP), postoperative interventricular septal thickness (IST), aortic regurgitation (AR), systolic anterior motion (SAM), and postoperative left ventricular flow velocity (LVFV) were significantly lower in the experimental group than in the control group (P < 0.05). The inner diameter of the left ventricular outflow tract (IDLV) was larger in the experimental group than in the control group (P < 0.05). There was no significant difference in the postoperative ejection fraction, atrioventricular block rate or complication rate between the two groups (P > 0.05). Conclusion A 3D-printed heart model for simulated surgery in vitro is conducive to formulating a more reasonable surgical plan and reducing the trauma and duration of surgery, thereby promoting the recovery and maintenance of the heart.

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“…Thirteen studies reported the incidence of PPM implantation following operations with concomitant valve and maze procedures, establishing an aggregate prevalence of 2.90% CI [0.61; 6.28], with prevalence ranging between 0% and 14.28% (44)(45)(46). Among included studies, 12% of the weight was appointed to a study with a prevalence of 0.49% for PPM implantation (47).…”

Section: Operations With Valve and Maze Proceduresmentioning

confidence: 99%

“…Among included studies, 12% of the weight was appointed to a study with a prevalence of 0.49% for PPM implantation (47). Based on reported data from 8 studies and 360 participants, a weighted average of the incidence of SND in the "valve-maze" group equaled 10.55% ± 19.87% (41, [44][45][46][48][49][50][51].…”

Section: Operations With Valve and Maze Proceduresmentioning

confidence: 99%

“…Combined cardiac surgeries were the most common intervention among all entered studies, with 50 intervention groups reporting PPM implantation in 34535patients and 29 studies reporting SND. The pooled estimate for the prevalence of post-operative PPM implantation was 3.308% CI [2.28; 4.489], with a range of 0% to 27.78% (44,45,52). One study by Feldman et al reported a prevalence of 27.78%, which is an outlier compared to studies with a similar population.…”

Section: Combined Cardiac Surgeriesmentioning

confidence: 99%

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Sinus node dysfunction and related permanent pacemaker implantation after major cardiac surgeries, systematic review, and meta-analysis

Dolama

Eghbal²,

Rezaee³

et al. 2023

Front. Cardiovasc. Med.

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BackgroundThere is no concise evidence or clinical guidelines regarding the incidence of sinus node dysfunction (SND) and permanent pacemaker (PPM) implantation following cardiac surgeries and their management approaches.ObjectiveWe aim to systematically review current evidence on the prevalence of SND, PPM implantation concerning it, and its risk factors in patients undergoing cardiac surgery.MethodFour electronic databases (Cochrane Library, Medline, SCOPUS, and Web of Science) were systematically searched for articles regarding SND after cardiovascular surgeries and reviewed by two independent researchers, and a third review in case of discrepancies. Using the random-effects model, a proportion meta-analysis was performed on data regarding PPM implantation. Subgroup analysis was performed for different interventions, and the possible effect of different covariates was evaluated using meta-regression.ResultsFrom the initial 2012 unique records, 87 were included in the study, and results were extracted. Pooled data from 38,519 patients indicated that the overall prevalence of PPM implantation due to SND after cardiac surgery was 2.87% (95% CI [2.09; 3.76]). The incidence of PPM implantation in the first post-surgical month was 2.707% (95% CI [1.657; 3.952]). Among the four main intervention groups, including valve, maze, valve-maze, and combined surgeries, maze surgery was associated with the highest prevalence (4.93%; CI [3.24; 6.92]). The pooled prevalence of SND among studies was 13.71% (95% CI [8.13; 20.33]). No significant relationship was observed between PPM implantation and age, gender, cardiopulmonary bypass time, or aortic cross-clamp time.ConclusionBased on the present report, patients undergoing the maze and maze-valve procedures are at higher risk of post-op SND, whereas lone valve surgery had the lowest prevalence of PPM implantation.Systematic Review RegistrationPROSPERO (CRD42022341896).

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Modified radial v/s biatrial maze for atrial fibrillation in rheumatic valvular heart surgery

Abstract: In patients with AF undergoing rheumatic valvular surgery, radiofrequency radial approach is as effective as modified Cox's maze III for conversion to NSR with better atrial transport function.

Cited by 3 publications

References 27 publications

Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

Surgical Treatment of Concomitant Atrial Fibrillation: Focus onto Atrial Contractility

Effect of 3D-printed hearts used in left ventricular outflow tract obstruction: a multicenter study

Sinus node dysfunction and related permanent pacemaker implantation after major cardiac surgeries, systematic review, and meta-analysis

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