Assessment of thromboembolism after the Cox-Maze procedure for chronic atrial fibrillation secondary to mitral valve lesion

To assess the occurrence of late thromboembolism after surgical repair of chronic atrial fibrillation (AF) simultaneously with repair of mitral valve using the Cox-Maze procedure. 69 patients underwent Cox 3 procedure, with no cryoablation simultaneously with mitral valvuloplasty or prosthesis. Mean...

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Published in:	Arquivos brasileiros de cardiologia Vol. 78; no. 4; pp. 374 - 381
Main Authors:	Kalil, Renato A K, Nesralla, Paula L M, Lima, Gustavo G, Leiria, Tiago L, Abrahao, Rogério, Moreno, Paulo, Prates, Paulo R, Sant'Anna, João R M, Nesralla, Ivo A
Format:	Journal Article
Language:	English
Published:	Brazil Sociedade Brasileira de Cardiologia - SBC 01-04-2002 Sociedade Brasileira de Cardiologia (SBC)
Subjects:	Adult Aged atrial fibrillation Atrial Fibrillation - etiology Atrial Fibrillation - surgery Brazil - epidemiology CARDIAC & CARDIOVASCULAR SYSTEMS Chronic Disease Female Heart Valve Diseases - complications Heart Valve Diseases - surgery Humans Male Middle Aged Mitral Valve - surgery Postoperative Complications - epidemiology Prevalence Retrospective Studies thromboembolism Thromboembolism - epidemiology Brazil mitral valve surgery atrial fibrillation thromboembolism
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Summary:	To assess the occurrence of late thromboembolism after surgical repair of chronic atrial fibrillation (AF) simultaneously with repair of mitral valve using the Cox-Maze procedure. 69 patients underwent Cox 3 procedure, with no cryoablation simultaneously with mitral valvuloplasty or prosthesis. Mean age was 49.9+/-13.2 years. Mean follow-up was of 31.7+/-19 months. Types of lesion were as follows: 33 (48%) stenoses, 23 (33%) insufficiencies, and 13 (19%) double lesions. Procedures were: 64 (93%) valvuloplasties, 3 (4%) biological and 2 (3%) mechanical prosthesis placement. There were 9 (13%) patients with previous systemic embolism and 2 (3%) had left atrial thrombi. Early mortality was 7% and late 1%. 2 patients (3%) were reoperated for mitral placement. At last evaluation, 10 patients (15%), were in AF. The remaining 59 (85%) were either in sinus / atrial rythm (74%) or under pacing (12%). There were no occurrence of early or late, systemic or pulmonary embolism. Permanent anticoagulation was employed in 16 cases, 10 in regular rythm and 6 in AF. The remaining 47 (75%), 2 in AF and 45 in regular rythm, did not receive anticoagulants. These results are in accordance with others series, where the occurrence of embolism was rare after maze procedure. Permanent systemic anticoagulation seems to be unnecessary in those cases.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0066-782X 1678-4170 0066-782X 1678-4170
DOI:	10.1590/S0066-782X2002000400004