Posted by Jack Drum on November 05, 2001 at 20:21:49:
In Reply to: Are the Results of the MAZE Procedure Long Lasting? posted by Murray Cohen on November 05, 2001 at 16:40:25:
Murry, there is no wide range long term follow up studies available that I know of. Some surgeons, (Dr. Cox who developed the Maze for one), keeps some records and are in the following article. You can also get some information from the medical facilities that perform the maze, but I am not certain how accurate they are. It seems that the long term follow up is mostly non existence from the medical community. I wish this was a different story, but this is as I know it.
I had my maze April 10, 1998, and have been AF free since I came out of the surgery. The only long term problem I had was the soreness in my sternum and at 2 years post Op. I had the wires removed and that problem was solved. I have talked to other mazers and one lady had AF to return after 6 years, (posted earlier on the board). There doesn't seem to be any long term medical problems arising from the maze surgery that I know of.An 8 1/2-year clinical experience with surgery for atrial fibrillation.
Cox JL, Schuessler RB, Lappas DG, Boineau JP.
Division of Cardiothoracic Surgery, Washington University School of Medicine, USA.
OBJECTIVE: The authors analyzed the clinical results during the first 8 1/2 years' experience with the Maze procedure for the surgical treatment of atrial fibrillation. SUMMARY BACKGROUND DATA: Atrial fibrillation occurs in 0.4% to 2% of the general population and in approximately 10% of patients older than 60 years of age. It is associated with significant morbidity and mortality. The irregular heartbeat causes discomfort, the loss of synchronous atrioventricular contraction compromises hemodynamics and the stasis of blood flow increases the vulnerability to thromboembolism. METHODS: From September 25, 1987 to March 1, 1996, 178 patients underwent the Maze procedure. Thirty-two patients underwent the Maze-I procedure, 15 underwent the Maze-II procedure, and 118 underwent the Maze-III procedure. Patients were analyzed for recurrence of atrial flutter and atrial fibrillation between 3 months and 8 1/2 years after surgery (n = 164). Patients were analyzed for atrial transport function, sinus nodule function, and postoperative pacemaker requirements. RESULTS: Ninety-three percent of all patients were arrhythmia free without any antiarrhythmic medication. Of the remaining patients with arrhythmia recurrence, all were converted to sinus rhythm with medical therapy. All patients were documented to have atrial transport function by either direct visualization, transesophageal echocardiography, or atrioventricular versus ventricular pacing at the same rate. Ninety-eight percent had documented right atrial function, and 94% had left atrial function. Of the 107 patients in this series who were documented to have a normal sinus node preoperatively, only 1 patient required a permanent pacemaker. CONCLUSION: The Maze procedure is an effective treatment for medically refractory atrial fibrillation in properly selected patients.