Résumé
BACKGROUNG: The aim of this study was to investigate the mid-term outcomes of our modifications to the maze procedure using cryoablation for treating atrial fibrillation associated with rheumatic mitral valve disease. MATERIAL AND METHOD: Between March 2000 and February 2004, 177 consecutive patients underwent the modified maze procedure with the use of cryoablation concomitant with mitral valve surgery for atrial fibrillation associated with rheumatic mitral valve disease, and were divided into three groups: (1) modified Cox-maze III (CM group, n=88); (2) modified Kosakai-maze (KM group, n=63); and (3) left atrial maze procedure (LA group, n=26). The postoperative and follow- up results were analyzed and compared between the groups. RESULT: There were three hospital deaths (1.7%) and no significant differences in the incidence of postoperative complications between the three groups. The operative time, such as the cardiopulmonary bypass and aortic crossclamp time, were significantly longer in the CM group than in the KM and LA groups, respectively (p<0.0001). The mean follow-up was 22.4+/-15.1 months (1~52.6 months) for all patients. One late death developed in the CM group (0.6%). At last follow-up, 139 patients exhibited sinus rhythm (79.9%), which was also regained in 67 patients (77.9%) in the CM group, 50 (80.7%) in the KM group and 22 (84.6%) in the LA group (p=0.743). The actuarial freedom from stroke at 4 years was 84.6+/-9.4% in the CM group, 95.0+/-4.9% in the KM group, and 92.9+/-6.9% in the LA group (p=0.916). CONCLUSION: The modified maze procedure using cryoablation is safe and effective in treating chronic atrial fibrillation associated with rheumatic mitral valve disease.