Right-Sided Maze Procedure for Atrial Tachyarrhythmias in Congenital Heart Disease

John M. Stulak, Joseph A. Dearani, Francisco J. Puga, Kenton J. Zehr, Hartzell V Schaff, Gordon K. Danielson

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

Background: Congenital heart disease (CHD) that causes right atrial dilatation is commonly associated with atrial flutter and/or fibrillation (AFl/F). To reduce late recurrence of AFl/F in patients undergoing repair of CHD, we utilized a concomitant right-sided maze procedure. Methods: From 1993 to 2003, 99 patients with CHD and associated AFl/F underwent a concomitant right-sided maze procedure at the time of CHD repair. Ages ranged from 9 to 72 years (median, 43 years). Atrial flutter and/or fibrillation was paroxysmal in 81 and chronic in 18; duration ranged from less than 1 month to 39.5 years (median, 2.9 years). Primary cardiac diagnoses were Ebstein anomaly (n = 47), other congenital tricuspid regurgitation (n = 19), univentricular heart (n = 11), isolated atrial septal defect (ASD, n = 8), tetralogy of Fallot (n = 8), and other (n = 6). Results: Other concomitant procedures included tricuspid valve repair or replacement (n = 70), ASD closure (n = 39), and pulmonary valve procedures (n = 18). There were 6 early deaths. At hospital dismissal, 83 patients were free of AFl/F and 63 were in sinus rhythm. Follow-up in 87 of the 93 early survivors extended up to 8 years (mean, 2.7 years). There were 4 late deaths, all from noncardiac causes. Of the 83 known late survivors, 77 (93%) were free of AFl/F. Eighty-two of the 83 survivors were in New York Heart Association class I or II. Conclusions: In patients with AFl/F associated with CHD, a concomitant right-sided maze procedure at the time of intracardiac repair is effective in reducing late recurrent AFl/F. Most patients enjoy an excellent quality of life.

Original languageEnglish (US)
Pages (from-to)1780-1785
Number of pages6
JournalAnnals of Thoracic Surgery
Volume81
Issue number5
DOIs
StatePublished - May 2006

Fingerprint

Atrial Flutter
Tachycardia
Atrial Fibrillation
Heart Diseases
Survivors
Ebstein Anomaly
Pulmonary Valve
Tricuspid Valve Insufficiency
Tricuspid Valve
Tetralogy of Fallot
Atrial Heart Septal Defects
Dilatation
Quality of Life
Recurrence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

Cite this

Right-Sided Maze Procedure for Atrial Tachyarrhythmias in Congenital Heart Disease. / Stulak, John M.; Dearani, Joseph A.; Puga, Francisco J.; Zehr, Kenton J.; Schaff, Hartzell V; Danielson, Gordon K.

In: Annals of Thoracic Surgery, Vol. 81, No. 5, 05.2006, p. 1780-1785.

Research output: Contribution to journalArticle

Stulak, John M. ; Dearani, Joseph A. ; Puga, Francisco J. ; Zehr, Kenton J. ; Schaff, Hartzell V ; Danielson, Gordon K. / Right-Sided Maze Procedure for Atrial Tachyarrhythmias in Congenital Heart Disease. In: Annals of Thoracic Surgery. 2006 ; Vol. 81, No. 5. pp. 1780-1785.
@article{53500af4b71f43569eb5590af7b6b605,
title = "Right-Sided Maze Procedure for Atrial Tachyarrhythmias in Congenital Heart Disease",
abstract = "Background: Congenital heart disease (CHD) that causes right atrial dilatation is commonly associated with atrial flutter and/or fibrillation (AFl/F). To reduce late recurrence of AFl/F in patients undergoing repair of CHD, we utilized a concomitant right-sided maze procedure. Methods: From 1993 to 2003, 99 patients with CHD and associated AFl/F underwent a concomitant right-sided maze procedure at the time of CHD repair. Ages ranged from 9 to 72 years (median, 43 years). Atrial flutter and/or fibrillation was paroxysmal in 81 and chronic in 18; duration ranged from less than 1 month to 39.5 years (median, 2.9 years). Primary cardiac diagnoses were Ebstein anomaly (n = 47), other congenital tricuspid regurgitation (n = 19), univentricular heart (n = 11), isolated atrial septal defect (ASD, n = 8), tetralogy of Fallot (n = 8), and other (n = 6). Results: Other concomitant procedures included tricuspid valve repair or replacement (n = 70), ASD closure (n = 39), and pulmonary valve procedures (n = 18). There were 6 early deaths. At hospital dismissal, 83 patients were free of AFl/F and 63 were in sinus rhythm. Follow-up in 87 of the 93 early survivors extended up to 8 years (mean, 2.7 years). There were 4 late deaths, all from noncardiac causes. Of the 83 known late survivors, 77 (93{\%}) were free of AFl/F. Eighty-two of the 83 survivors were in New York Heart Association class I or II. Conclusions: In patients with AFl/F associated with CHD, a concomitant right-sided maze procedure at the time of intracardiac repair is effective in reducing late recurrent AFl/F. Most patients enjoy an excellent quality of life.",
author = "Stulak, {John M.} and Dearani, {Joseph A.} and Puga, {Francisco J.} and Zehr, {Kenton J.} and Schaff, {Hartzell V} and Danielson, {Gordon K.}",
year = "2006",
month = "5",
doi = "10.1016/j.athoracsur.2005.10.046",
language = "English (US)",
volume = "81",
pages = "1780--1785",
journal = "Annals of Thoracic Surgery",
issn = "0003-4975",
publisher = "Elsevier USA",
number = "5",

}

TY - JOUR

T1 - Right-Sided Maze Procedure for Atrial Tachyarrhythmias in Congenital Heart Disease

AU - Stulak, John M.

AU - Dearani, Joseph A.

AU - Puga, Francisco J.

AU - Zehr, Kenton J.

AU - Schaff, Hartzell V

AU - Danielson, Gordon K.

PY - 2006/5

Y1 - 2006/5

N2 - Background: Congenital heart disease (CHD) that causes right atrial dilatation is commonly associated with atrial flutter and/or fibrillation (AFl/F). To reduce late recurrence of AFl/F in patients undergoing repair of CHD, we utilized a concomitant right-sided maze procedure. Methods: From 1993 to 2003, 99 patients with CHD and associated AFl/F underwent a concomitant right-sided maze procedure at the time of CHD repair. Ages ranged from 9 to 72 years (median, 43 years). Atrial flutter and/or fibrillation was paroxysmal in 81 and chronic in 18; duration ranged from less than 1 month to 39.5 years (median, 2.9 years). Primary cardiac diagnoses were Ebstein anomaly (n = 47), other congenital tricuspid regurgitation (n = 19), univentricular heart (n = 11), isolated atrial septal defect (ASD, n = 8), tetralogy of Fallot (n = 8), and other (n = 6). Results: Other concomitant procedures included tricuspid valve repair or replacement (n = 70), ASD closure (n = 39), and pulmonary valve procedures (n = 18). There were 6 early deaths. At hospital dismissal, 83 patients were free of AFl/F and 63 were in sinus rhythm. Follow-up in 87 of the 93 early survivors extended up to 8 years (mean, 2.7 years). There were 4 late deaths, all from noncardiac causes. Of the 83 known late survivors, 77 (93%) were free of AFl/F. Eighty-two of the 83 survivors were in New York Heart Association class I or II. Conclusions: In patients with AFl/F associated with CHD, a concomitant right-sided maze procedure at the time of intracardiac repair is effective in reducing late recurrent AFl/F. Most patients enjoy an excellent quality of life.

AB - Background: Congenital heart disease (CHD) that causes right atrial dilatation is commonly associated with atrial flutter and/or fibrillation (AFl/F). To reduce late recurrence of AFl/F in patients undergoing repair of CHD, we utilized a concomitant right-sided maze procedure. Methods: From 1993 to 2003, 99 patients with CHD and associated AFl/F underwent a concomitant right-sided maze procedure at the time of CHD repair. Ages ranged from 9 to 72 years (median, 43 years). Atrial flutter and/or fibrillation was paroxysmal in 81 and chronic in 18; duration ranged from less than 1 month to 39.5 years (median, 2.9 years). Primary cardiac diagnoses were Ebstein anomaly (n = 47), other congenital tricuspid regurgitation (n = 19), univentricular heart (n = 11), isolated atrial septal defect (ASD, n = 8), tetralogy of Fallot (n = 8), and other (n = 6). Results: Other concomitant procedures included tricuspid valve repair or replacement (n = 70), ASD closure (n = 39), and pulmonary valve procedures (n = 18). There were 6 early deaths. At hospital dismissal, 83 patients were free of AFl/F and 63 were in sinus rhythm. Follow-up in 87 of the 93 early survivors extended up to 8 years (mean, 2.7 years). There were 4 late deaths, all from noncardiac causes. Of the 83 known late survivors, 77 (93%) were free of AFl/F. Eighty-two of the 83 survivors were in New York Heart Association class I or II. Conclusions: In patients with AFl/F associated with CHD, a concomitant right-sided maze procedure at the time of intracardiac repair is effective in reducing late recurrent AFl/F. Most patients enjoy an excellent quality of life.

UR - http://www.scopus.com/inward/record.url?scp=33646847803&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646847803&partnerID=8YFLogxK

U2 - 10.1016/j.athoracsur.2005.10.046

DO - 10.1016/j.athoracsur.2005.10.046

M3 - Article

VL - 81

SP - 1780

EP - 1785

JO - Annals of Thoracic Surgery

JF - Annals of Thoracic Surgery

SN - 0003-4975

IS - 5

ER -