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Ann Thorac Surg 2001;72:1251-1255
© 2001 The Society of Thoracic Surgeons

Original article: cardiovascular

Predictors for atrial transport function after mini-maze operation

Erwin P. Bauer, MDa, Zoltan A. Szalay, MDa, Roland R. Brandt, MDb, Heinz F. Pitschner, MDb, Georg Bachmann, MDc, Hans-Peter Brunner-La Rocca, MDd, Wolf Peter Klövekorn, MDa

a Department of Cardiothoracic Surgery, Kerckhoff-Clinic Foundation, Bad Nauheim, Germany
b Department of Cardiology, Kerckhoff-Clinic Foundation, Bad Nauheim, Germany
c Department of Radiology, Kerckhoff-Clinic Foundation, Bad Nauheim, Germany
d Department of Cardiology, University Hospital, Zürich, Switzerland

Address reprint requests to Dr Bauer, Department of Cardiothoracic Surgery, Kerckhoff-Clinic Foundation, Benekestrasse 2-8, D-61231 Bad Nauheim, Germany
e-mail: epb53{at}yahoo.com

Presented at the Thirty-seventh Annual Meeting of The Society of Thoracic Surgeons, New Orleans, LA, Jan 29–31, 2001.

Background. Restoration of atrial transport function (ATF) is a major goal of the maze procedure. This prospective study was undertaken to evaluate predictors of left atrial transport function in patients undergoing a mini-variant of the maze III procedure 3 and 12 months postoperatively.

Methods. Mini-maze operation was performed in 72 patients with a mean age of 64 ± 8.7 years during a 5-year period. Seventy of 72 (97%) had combined procedures. Clinical and electrophysiologic examination was carried out before surgery, and 3 and 12 months postoperatively.

Results. Early mortality was 1.4% (1 of 72 patients) and late death occurred in 5.6% (4 of 71 patients). After 3 months, 54 of 68 (80%) patients showed sinus rhythm, and 48 of 60 (80%) after 12 months. ATF was restored in 87% (echocardiography) and 82% (magnetic resonance imaging) after 3 months, and in 86% (echocardiography) and 78% (magnetic resonance imaging) after 12 months. Independent predictors for ATF restoration after 12 months were better preoperative left ventricular function (p = 0.02), and smaller preoperative left atrial diameter (p = 0.005). Correlation between echocardiography and magnetic resonance imaging was 80% after 12 months.

Conclusions. Restoration of ATF after mini-maze procedure is achieved in over 80%. Independent predictors for ATF restoration are smaller preoperative left atrial diameter and better preoperative left ventricular ejection fraction.




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