Effectiveness of the CryoMAZE Surgery on the Open Heart in Patients with Atrial Fibrillation
Introduction. Atrial fibrillation (AF) is the most common arrhythmia in patients with cardiac surgery pathology. Preservation of atrial fibrillation after cardiac surgery is associated with the increased mortality, thromboembolic complications, reduced quality of life of patients. Today, the gold standard in AF surgery is the operation MAZE. Purpose. To analyze the first experience of performing the open-heart сryoMAZE operation in patients with atrial fibrillation in the Scientific and Practical Center of Cardiology. Materials and methods. There were studied the results of the first 20 “cryoMAZE”surgery performed simultaneously with the surgical correction of the main heart disease in the period from January to December 2018. The average age of patients was 61±8 years (39-73 years), of which 55% were female patients. Persistent / long-persistent AF was present in the majority of patients (80%) before surgery with the average duration 22.5±20 months. 65% of patients belonged to NYHA FC III and IV. The systolic pressure in the pulmonary artery was 45±9 mmHg before the operation. The average size (antero-posterior) of the left atrium before the operation was 49±6 mm. The rhythm control in the hospital and long-term periods was performed using Holter monitoring in the majority of patients (92%). Results and discussion. All operations were performed from the median sternotomy under extracorporeal circulation. The ablation stage was carried out with Atricure’s cryoForm. There were no deaths in the hospital period. We did not observe any complications associated with performing of the cryoMAZE operation. The long-term period was studied in all patients (n=20). In the follow-up period of 6.8±2.4 months after the surgery, 85% of patients had sinus rhythm. Among them, 1 (5%) patient needed sequential (DDDR) cardiac stimulation. Conclusion. The open-heart cryoMAZE, performed simultaneously with the correction of the main cardiac pathology, is an effective and safe surgical tool for treatment of patients with paroxysmal and persistent atrial fibrillation.