Restoration of Atrial Mechanical Function after Maze Operation

ABSTRACT

BACKGROUND: Maze operation is aimed for the restoration of sinus rhythm. But restoration of atrial mechanical function has not been demonstrated in all patients converted to sinus rhythm. METHOD: From Apr. 1994 to Feb. 1996, maze operations were performed in 32 pts (MF=1319, mean age 47.1+/-9.0 years) combined with valvular surgery(n=26), CABG(n=3), and others(n=3). Presence of atrial mechanical function was serially examined before discharge, in 3mo, 6mo and 1 yr using Doppler echocardiography. RESULTS: In 22 patients(pts), sinus rhythm was maintained without antiarrhythmic agents. In 4 patients antiarrhythmic agent was required to maintain sinus rhythm while in another 4 patients showed paroxysmal Af despite of the treatment with antiarrhythmic agents. In 30 pts with sinus rhythm or paroxysmal Af, right atrial function was restored in all pts while left atrial function was restored in only 19/30(63%). Peak A velocity and A/E ratio were 0.38+/-0.12m/s, 0.74, respectively on tricuspid inflow(TI), and 0.46+/-0.14m/s, 0.40, respectively on mitral inflow(MI ). MI peak A velocity and A/E ratio were significantly lower than the 16 control postoperative pts (0.75<0.29, 0.80 p+/-0.01). In pts with atrial mechanical function, the duration of Af was significantly shorter than patients without atrial function (1.9+/-2.9 yr vs 7.1+/-3.0 yr p<0.01), but no significant differences in the LA size and volume. CONCLUSION: Maze operation is effective in restoring sinus rhythm. But restoration of sinus rhythm was not always associated with restoration of atrial mechanical function, and the restored atrial function was incomplete. The duration of Af could be a markker for predicting the restoration of atrial function.