COMBINED TREATMENT OF MITRAL REGURGITATION AND ATRIAL-FIBRILLATION WITH VALVULOPLASTY AND THE MAZE PROCEDURE

Successful mitral valve repair in a patient who continues to have chronic atrial fibrillation (AF) after surgery is only a limited success because of the ongoing risks with lifelong AF. For patients with AF for >1 year and left atrial diameter >60 mm, the likelihood of resuming sinus rhythm after mitral valve surgery was shown to be <10% in 1 series.1 These patients may have impaired hemodynamic function as a result of loss of atrial contraction, symptomatic tachycardia, side effects from antiarrhythmic and anticoagulant drugs, and thromboembolic events. The Maze procedure, as originated by Cox et al,2 is an operation designed to correct the consequences of AF by restoring normal sinus rhythm and atrial contraction in both atria. This report describes the use of this procedure for a patient undergoing mitral valve repair in whom the return of sinus rhythm was unlikely due to long-standing AF with dilated atria. © 1993.