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Comparative Results of Maze Procedure
for Chronic Atrial
Fibrillation in Rheumatic and Degenerative Mitral Valve Disease
Kalil Renato A.K.; Cunha Bartira; Albrecht
Álvaro S.; Moreno Paulo;
Abrahão Rogério; Prates Paulo R.; SantAnna João R.M.; Nesralla Ivo A.
Instituto de Cardiologia do Rio Grande do Sul / FUC.
Porto Alegre, RS, Brasil.
The results of maze procedure in rheumatic mitral valve disease are subjected to debate. This paper reports medium term results in rheumatic and degenerative mitral valve surgery associated with maze procedure.
From 1994 to 1997, 57 patients were operated on. They were divided in two groups; R (rheumatic) 40 patients and D (degenerative) 17. In group R 8 (20%) male and 32 (80%) female. Group D: 8 (47%) male and 9 (53%) female (NS). Age in R=47±11 and D 54±17 years (p<0.05) Left atrial size was 6.1±1.1 cm in R and 5.9±1.2 in D (NS).
There were 3 hospital deaths, 1 (2.5%) in R and 2 (12%) in D. One D patient (7%) died late. Pacemakers were implanted in 4 (10%) R and 2 (17%) D (NS). There were no significant differences regarding surgical duration of perfusion or myocardial ischemia, antiarrhythmic medications, immediate or late cardiac rythms and occurrence of arrythmias. Ergometric evaluation for measuring chronotropic response revealed a normal response in 6 (25%) R and 1 (10%) D at a mean of 16,6 months p.o. In the lower response group, 3 (12.5%) R and 6 (60%) D had intermediate values (p=0.009) and 15 (62.5%) R versus 3 (30%) D had values below 75% of expected heart rate (p=0.09).
It is concluded that rheumatic or degenerative ethiology of mitral valve disease does not influence results of maze procedure in this patient population. Mean chronotropic response to exercise tends to be lower in degenerative patients.
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