OBJECTIVE

To analyze the immediate outcomes of Cryo-Maze procedure in mitral valve repair through right-sided minithoracotomy.

MATERIAL AND METHODS

The study presents postoperative outcomes in four patients with severe mitral regurgitation complicated by atrial fibrillation. All patients underwent cryo-isolation of pulmonary vein ostia and posterior left atrial wall combined with mitral valve repair via right-sided mini-thoracotomy. Treatment period was 2023—2024 with outcomes assessed in 2024.

RESULTS

Mean surgery time was 283.7±53 min, cardiopulmonary bypass time — 189.2±25 min, aortic cross-clamping time — 106.2±35 min. Duration of surgery was influenced by specifics of surgical approach and learning curve. By the end of the procedure, all patients restored sinus rhythm. In most cases, ICU stay did not exceed 24 hours. In postoperative period, atrial fibrillation paroxysms were recorded in 2 patients, and one required electrical cardioversion. No permanent pacemaker implantation or conversion to alternative surgical approach was observed. At discharge, all patients maintained sinus rhythm and they were discharged within 14 days. One patient died after 38 postoperative days due to multiple organ failure following severe bilateral viral-bacterial pneumonia.

CONCLUSION

Advances in minimally invasive techniques for open cardiac surgery enable Cryo-Maze procedure via right-sided mini-thoracotomy. Cryo-Maze technique for atrial fibrillation treatment combined with mitral valve repair via right-sided mini-thoracotomy demonstrates efficacy and safety. Current technological developments in surgical ablation offer opportunities to refine this method, particularly in specialized centers.