Long term effectiveness of surgical cryoMAZE ablation for chronic atrial fibrillation in patients undergoing surgery for severe mitral valve regurgitation

Authors: R. Neuwirth 1;  M. Fiala 1;  P. Branny 2;  J. Novosad 2;  M. Urban 2;  O. Jiravský 1;  J. Chovančík 1;  R. Nevřalová 1;  M. Branny 1
Authors‘ workplace: Oddělení kardiologie, Kardiocentrum, Nemocnice Podlesí a. s., Třinec, přednosta prim. MUDr. Marian Branny 1;  Oddělení kardiochirurgie, Kardiocentrum, Nemocnice Podlesí a. s., Třinec, přednosta prim. MUDr. Piotr Branny 2
Published in: Vnitř Lék 2007; 53(2): 151-156
Category: Original Contributions


The objective of the study was to evaluate effectiveness of surgical cryoMAZE ablation for chronic atrial fibrillation (AF) in patients undergoing mitral valve surgical intervention.

Forty-seven patients (31 females), aged 67.3 ± ± 7.3 years who underwent surgical intervention for severe mitral regurgitation were studied. Mitral valvuloplasty was performed in 21 patients, and mitral valve replacement in 26 patients. Combined procedure was employed in 35 patients; simultaneous aortocoronary bypass was performed in 16 patients, tricuspid valvuloplasty (TVP) in 5 patients, and aortic valve replacement (AVR) in 5 patients.

The mean follow-up time was 19 ± 10 months. After 6 or 12 months 36 or 32 patients were seen and 23 (64 %) or 22 (69 %) of them were in stable sinus rhythm (SR), respectively. In the subset of 24 patients with simultaneous intervention on a different valve (TVP or AVR), after 6 or 12 months, 14 (74 %) or 15 (83 %) patients had stable SR, respectively. In the follow-up period, 2 patients underwent successful catheter ablation for type I atrial flutter or for a residual left atrial atypical flutter.

In the study using the method of cryoMAZE ablation for chronic AF performed during the mitral valve surgical intervention, a long-term stable SR was achieved in a high proportion of patients, particularly in patients with simultaneous intervention on two or three different valves.

Key words:
cryoMAZE ablation – chronic atrial fibrillation – mitral valve surgery


1. Blackshear JL, Odel JA. Appendance obliteration to reduce stroke in cardiac surgical patients with atrial fibrillation. Ann Thorac Surg 1996; 61: 755-759.

2. Cox JL, Schuessler RB, Dagostino HJ et al. The surgical treatment of atrial fibrilation III. Development of a definite surgical procedure. J Thorac Cardiovascular Surg 1991, 101: 569-583.

3. Cox JL. The surgical treatment of atrial fibrilation IV. Surgical technique. J Thorac Cardiovascular Surg 1991; 101: 584-592.

4. Cox JL. The importance of cryoablation of the coronary sinus during the Maze procedure. Semin Thorac Cardiovasc Surg 2000; 12: 20-24.

5. Dominik J. Chlopenní srdeční vady. In: Dominik J. Kardiochirurgie. Praha: Grada Publishing 1998; 61-100.

6. Gillinov AM, McCarthy PM Atricure bipolar radiofrequency clamp for intraoperativ ablation of atrial fibrillation. Ann Thorac Surg 2002; 74: 2165-2168.

7. Gillinov AM, Smerida NG, Cosgrowe DM et al. Microwave ablation of atrial fibrillation during mitral valve operations. Ann Thorac Surg 2002; 74: 1259-1261.

8. James SG, John L, James B et al. A Multi-Institutional Experience With the Cryomaze Procedur. Ann Thorac Surg 2005; 80: 876-880.

9. Kautzner J, Pirk J, Bytešník J et al. První zkušenosti s chirurgickou lineární ablací chronické fibrilace síní pomocí radiofrekvenční energie. Cor Vasa 2001; 43: 37.

10. Kosakai Y, Kawaguchi AT, Isobe F et al. Cox maze procedure for chronic atrial fibrillation associated with mitral valve disease. J Thorac Cardiovasc Surg 1994; 108: 1048-1055.

11. Melo JQ, Adragao PR, Neves J et al. Elektrosurgical treatment of atrial fibrillation with a new intraoperativ radiofrequency ablation catheter. J Thorac Cardovasc Surg 1999; 47: Suppl 370-372.

12. Mohr FW, Fabricius AM, Falk V et al. Curative treatment of atrial fibrilation with intraoperative radiofrequency ablation: short-term and mid-term results. J Thorac Cardiovasc Surg 2002; 123: 919-927.

13. Pasic M, Bergs P, Muller P et al. Intraoperative maze ablation for atrial fibrillation: the Berlin modification. Ann Thorac Surg 2001; 72: 1484-1494.

14. Szalay ZA, Skwara W, Klovekorn WP et al. Predictors of failure to cure atrial fibrillation with the mini maze operation. J Card Surg 2004; 19: 1-6.

15. Thomas SP, Nunn GR, Nicholson IA et al. Mechanism, localization and cure of atrial arrhytmias occuring after a new intraoperativ endocardial radiofrequency ablation procedur for atrial fibrillation. J Am Coll Cardiol 2000; 35: 442-450.

Diabetology Endocrinology Internal medicine
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.


Don‘t have an account?  Create new account