[Maze procedure for chronic atrial fibrillation associated with mitral valve disease].

From May 1995 to October 1996, 20 patients with mitral valve disease underwent the maze procedure for chronic atrial fibrillation and mitral valve replacement or mitral valvuloplasty. Epicardial mapping data demonstrated that the large macrorecurre flutter circuit was located in left atrium (14/20) and complex fibrillation in right atrium (18/20) of the majority of patients. No early death occurred. 20 patients were followed up for at least 3 months (range 3-20 months) and 14 patients for at least 1 year after operation, sinus rhythm and atrioventricular synchrony were restored (100%), atrial fibrillation was not induced by electrophysiologic study. The right and left atrial transport function was preserved (100%) by Doppler echocardiogram tracings. One patient died from acute necrotic hepatitis, 4 and half months after operation. Cox maze procedure was modified, atrial flutter and atrial fibrillation never occurred. In this study, the electrophysiologic mechanism of chronic atrial fibrillation associated with mitral valve disease, indications of operation and clinical results are discussed.