Effect of Maze Procedure in Patients with Atrial Fibrillation Undergoing Valve Replacement
Mitsuhiro Hirata MD, Ko Bando MD, Junjiro Kobayashi MD, Yoshikado Sasako MD, Osamu Tagusari MD, Kazuo Niwaya MD, Soichiro Kitamura MD

Between 1992 and 2000, 241 patients underwent the maze procedure combined with valve replacement. Patients were allocated to three groups: aortic valve replacement (AVR/maze, n = 16); mitral valve replacement (MVR/maze, n = 148); and combined aortic and mitral valve replacement (DVR/maze, n = 77). Hospital mortality was 0-3.9%. Elimination of atrial fibrillation (AF) at discharge was achieved in ~75% of patients. Freedom from recurrence of AF was 71.2% in AVR/maze patients, 68.2% in MVR/maze, and 64.0% in DVR/maze at five years postoperatively. Freedom from stroke was 93.6% in patients with regular rhythm, and 80.9% in patients with atrial fibrillation at five years after surgery (p = 0.03). By multivariate analysis, the risk factor for late stroke was recurrence of AF after surgery. The combined maze procedure and valve replacement is safe and effective in selected patients. Restoration of regular rhythm significantly reduced the incidence of late stroke.