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Evseev E.P.

Petrovsky National Research Center of Surgery

Balakin E.V.

Petrovsky National Research Center of Surgery

Aidamirov I.A.

Petrovsky National Research Center of Surgery

Fomin M.A.

Petrovsky National Research Center of Surgery

Botashev A.A.

Petrovsky National Research Center of Surgery

Fedulova S.V.

Petrovsky National Research Center of Surgery

Malakhova M.V.

Petrovsky National Research Center of Surgery

Korchazhkina N.B.

Petrovsky National Research Center of Surgery

Kotenko K.V.

Petrovsky National Research Center of Surgery

Popov S.O.

Petrovsky National Research Center of Surgery

Immediate outcomes of simultaneous Cox-Maze procedure in patients with isolated and multivalvular heart defects via right mini-thoracotomy

Authors:

Evseev E.P., Balakin E.V., Aidamirov I.A., Fomin M.A., Botashev A.A., Fedulova S.V., Malakhova M.V., Korchazhkina N.B., Kotenko K.V., Popov S.O.

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Journal: Pirogov Russian Journal of Surgery. 2024;(12‑2): 18‑24

DOI: 10.17116/hirurgia202412218

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To cite this article:

Evseev EP, Balakin EV, Aidamirov IA, et al. . Immediate outcomes of simultaneous Cox-Maze procedure in patients with isolated and multivalvular heart defects via right mini-thoracotomy. Pirogov Russian Journal of Surgery. 2024;(12‑2):18‑24. (In Russ.)
https://doi.org/10.17116/hirurgia202412218

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OBJECTIVE

To evaluate the immediate outcomes and safety of simultaneous Maze procedure in patients with isolated and multivalvular heart disease via right-sided mini-thoracotomy.

MATERIAL AND METHODS

A retrospective analysis of postoperative outcomes included 21 patients with various valvular heart diseases and atrial septal defects with atrial fibrillation. All patients underwent heart valve surgery with cryoablation (left atrial, right atrial or biatrial «Maze» approach) via right-sided mini-thoracotomy.

RESULTS

There were no unfavorable outcomes. Mean surgery time was 214 min (193; 241), cardiopulmonary bypass time — 116 min (96; 133), aortic cross-clamping time — 90 min (76; 97). Intraoperative blood loss was approximately 500 mL (400; 600). Conversion to sternotomy was required in 1 case (4.8%). In most case (90.5%), length of ICU-stay was 1 day, hospital-stay — 7 days (7; 10). Twenty patients (95.2%) had sinus rhythm at discharge.

CONCLUSION

Simultaneous heart valve surgery and Maze procedure are effective and reproducible. This approach is associated with low mortality, preservation of thoracic wall stability, favorable cosmetic results and stable sinus rhythm in 95.4% of patients. Left atrial and biatrial variants of this procedure can be successfully performed depending on the type of atrial fibrillation and specific valve disease.

Keywords:

right mini-thoracotomy
minimally invasive surgery
heart valve disease
mitral valve disease
atrial septal defect
«Maze»
atrial fibrillation

Authors:

Evseev E.P.

Petrovsky National Research Center of Surgery

Balakin E.V.

Petrovsky National Research Center of Surgery

Aidamirov I.A.

Petrovsky National Research Center of Surgery

Fomin M.A.

Petrovsky National Research Center of Surgery

Botashev A.A.

Petrovsky National Research Center of Surgery

Fedulova S.V.

Petrovsky National Research Center of Surgery

Malakhova M.V.

Petrovsky National Research Center of Surgery

Korchazhkina N.B.

Petrovsky National Research Center of Surgery

Kotenko K.V.

Petrovsky National Research Center of Surgery

Popov S.O.

Petrovsky National Research Center of Surgery

Received:

12.08.2024

Accepted:

07.09.2024

List of references:

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