FOR THE MEDICAL PRACTITIONER
Cardiovascular Surgery
doi: 10.25005/2074-0581-2024-26-2-308-313
ASSESSMENT OF LONG-TERM OUTCOMES OF BIATRIAL COX-MAZE IV CRYOABLATION IN COMBINED CARDIAC SURGERY

R.N. KOMAROV1, D.A. MATSUGANOV2,3, M.D. NUZHDIN2, D.O. BYSTROV4

1I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
2Chelyabinsk Regional Clinical Hospital, Chelyabinsk, Russian Federation
3South Ural State Medical University, Chelyabinsk, Russian Federation
4First City Clinical Hospital named after E.E. Volosevich, Arkhangelsk, Russian Federation

Objective: To analyze the results of biatrial (BA) Cox-Maze IV cryoablation during combined heart surgeries

Methods: The study involved 88 patients who underwent BA cryoablation and concomitant cardiac surgery. The inclusion criteria were patients who underwent BA cryoablation and concomitant cardiac surgery between 2019 and 2021. The types of atrial fibrillation (AF) observed were as follows: persistent – 39 (44.3%) and long-term persistent – 49 (55.7%) cases

Results: The following procedures were performed: coronary artery bypass grafting (CABG) in 5 cases (5.7%), isolated valve repair in 67 cases (76.1%), and valve repair combined with CABG in 16 cases (18.2%). The aortic cross-clamping (ACC) time was 143 minutes [range: 120.5-161.5], and the cardiopulmonary bypass time was 193.5 minutes [range: 168.5-210]. BA Cox-Maze IV cryoablation was performed in all cases. The hospital mortality rate was 1.1%. Sinus rhythm was restored at the time of discharge in 81 patients (92%). Two patients (2.3%) received a permanent pacemaker. The survival rates at 1, 2, 3, and 4 years were 88.9%, 88.9%, 82.2%, and 73.5%, respectively. The rates of remaining free from AF at 1, 2, 3, and 4 years were 87.5%, 80.7%, 68.3%, and 38.6%, respectively.

Conclusion: Cryoablation using the maze procedure as a concomitant step during cardiac surgery is a safe procedure with a high likelihood of restoring sinus rhythm.

Keywords: Atrial fibrillation, correction of valve pathology, Maze procedure, sinus rhythm.

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References
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Authors' information:

Komarov Roman Nikolaevich,
Doctor of Medical Sciences, Full Professor, Director of the Clinic of Aortic and Cardiovascular Surgery, I.M. Sechenov First Moscow State Medical University; Head of the Department of Cardiovascular Surgery, I.M. Sechenov First Moscow State Medical University
ORCID ID: 0000-0002-3904-6415
SPIN: 7770-8417
Author ID: 348685
E-mail: komarov_r_n@staff.sechenov.ru

Matsuganov Denis Alekseevich,
Candidate of Medical Sciences, Cardiovascular Surgeon of the Department of Cardiac Surgery, Chelyabinsk Regional Clinical Hospital; Assistant of the Department of Anatomy and Operative Surgery, South Ural State Medical University
ORCID ID: 0000-0002-5393-7070
SPIN: 7129-0833
Author ID: 1154329
E-mail: denmacug@yandex.ru

Nuzhdin Mikhail Dmitrievich,
Candidate of Medical Sciences, Head of the Cardiac Surgery Department, Chelyabinsk Regional Clinical Hospital
ORCID ID: 0000-0002-7269-6727
SPIN: 3962-2213
Author ID: 1170320
E-mail: austesla2022@gmail.com

Bystrov Dmitriy Olegovich,
Candidate of Medical Sciences, Cardiovascular Surgeon of the Department of Cardiac Surgery, First City Clinical Hospital named after E.E. Volosevich
ORCID ID: 0000-0002-4909-4381
SPIN: 8033-5388
Author ID: 823039
E-mail: dr.bystrov@gmail.com

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Matsuganov Denis Alekseevich
Candidate of Medical Sciences, Cardiovascular Surgeon of the Department of Cardiac Surgery, Chelyabinsk Regional Clinical Hospital; Assistant of the Department of Anatomy and Operative Surgery, South Ural State Medical University

456501, Russian Federation, Chelyabinsk Region, Sosnovsky District, Kremenkul, MD Zelyonyy Mys, 17 Main Street

Tel.: +7 (922) 7470086

E-mail: denmacug@yandex.ru

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