Khirurgiia · 2024
[Immediate outcomes of simultaneous Cox-Maze procedure in patients with isolated and multivalvular heart defects via right mini-thoracotomy].
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Evseev E P, Balakin E V, Aidamirov I A, Fomin M A, Botashev A A, Fedulova S V, Malakhova M V, Korchazhkina N B, Kotenko K V, Popov S O
Аннотация
OBJECTIVE: To evaluate the immediate outcomes and safety of simultaneous Maze procedure in patients with isolated and multivalvular heart disease via right-sided mini-thoracotomy.
MATERIAL AND METHODS: A retrospective analysis of postoperative outcomes included 21 patients with various valvular heart diseases and atrial septal defects with atrial fibrillation. All patients underwent heart valve surgery with cryoablation (left atrial, right atrial or biatrial «Maze» approach) via right-sided mini-thoracotomy.
RESULTS: There were no unfavorable outcomes. Mean surgery time was 214 min (193; 241), cardiopulmonary bypass time - 116 min (96; 133), aortic cross-clamping time - 90 min (76; 97). Intraoperative blood loss was approximately 500 mL (400; 600). Conversion to sternotomy was required in 1 case (4.8%). In most case (90.5%), length of ICU-stay was 1 day, hospital-stay - 7 days (7; 10). Twenty patients (95.2%) had sinus rhythm at discharge.
CONCLUSION: Simultaneous heart valve surgery and Maze procedure are effective and reproducible. This approach is associated with low mortality, preservation of thoracic wall stability, favorable cosmetic results and stable sinus rhythm in 95.4% of patients. Left atrial and biatrial variants of this procedure can be successfully performed depending on the type of atrial fibrillation and specific valve disease.
MATERIAL AND METHODS: A retrospective analysis of postoperative outcomes included 21 patients with various valvular heart diseases and atrial septal defects with atrial fibrillation. All patients underwent heart valve surgery with cryoablation (left atrial, right atrial or biatrial «Maze» approach) via right-sided mini-thoracotomy.
RESULTS: There were no unfavorable outcomes. Mean surgery time was 214 min (193; 241), cardiopulmonary bypass time - 116 min (96; 133), aortic cross-clamping time - 90 min (76; 97). Intraoperative blood loss was approximately 500 mL (400; 600). Conversion to sternotomy was required in 1 case (4.8%). In most case (90.5%), length of ICU-stay was 1 day, hospital-stay - 7 days (7; 10). Twenty patients (95.2%) had sinus rhythm at discharge.
CONCLUSION: Simultaneous heart valve surgery and Maze procedure are effective and reproducible. This approach is associated with low mortality, preservation of thoracic wall stability, favorable cosmetic results and stable sinus rhythm in 95.4% of patients. Left atrial and biatrial variants of this procedure can be successfully performed depending on the type of atrial fibrillation and specific valve disease.
Предметные рубрики MeSH
HumansMaleFemaleThoracotomyAtrial FibrillationHeart Valve DiseasesMiddle AgedRetrospective StudiesMaze ProcedureHeart Septal Defects, AtrialCryosurgeryAdultPostoperative ComplicationsOutcome and Process Assessment, Health CareTreatment OutcomeHeart Valve Prosthesis ImplantationOutcome Assessment, Health Care