A Modification of Maze III Procedure to Improve Left Atrial Function.
- Author:
Jae won LEE
1
;
Tae Seung SONG
;
Suk Joong CHOO
;
Sang Kweon LEE
;
Je Kyoun SHIN
;
Myung Keun SONG
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan.
- Publication Type:Original Article
- Keywords:
Arrhythmia surgery;
Atrial fibrillation;
Surgery method
- MeSH:
Atrial Fibrillation;
Atrial Function, Left*;
Echocardiography;
Electrocardiography, Ambulatory;
Heart Rate;
Humans
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
1999;32(10):903-909
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: The current study was undertaken to investigate the results of a modification in the conventional Maze III Procedure devised by the authors. The aim of the technical modification was in improving the left atrial contractility. MATERIAL AND METHOD: Between July 1997 and December 1998, 34 patients with chronic atrial fibrillation for more than 1 year duration underwent a modified Maze III procedure. The assessment of the left atrial function was made by various echocardiographic measurements and SA nodal recovery was evaluated by HRV Holter monitoring. RESULT: All 34 patients were in sinus rhythm. On echocardiography, right atrial contraction was detected in 32 patients(94.1%) and left atrial contraction in 33 patients(97.1%). The echocardiographic A wave at 1, 6, and 12 months or more were 50.5+/-31.5, 62.1+/-25.1, 66+/-20.6 cm/sec, respectively, and the E wave measurements at the same time points were 152+/-31.1, 134.4+/-35.2, 133+/-27.5 cm/sec. The corresponding A/E ratios were 0.32+/-0.13, 0.48+/-0.18, 0.5+/-0.15, showing a rising trend. Treadmill evaluation at 6 months showed a mean 82% increase in heart rate after excising, and the SDNN and SDANN upon HRV Holter at 1 and 3 months postoperatively were 65.3+/-28.1/87.8+/-27.2 ms, and 60.0+/-24.1/83.4+/-25.7 ms, respectively, showing a predoinant autonomic recovery in the parasympathetic system(PSDNN = 0.01, PSDANN =0.015). CONCLUSION: The results of our data suggest that the current modification in the conventional Maze III Procedure was efective in enhancing the postoperative left atrial contractility.
