A Radiofrequency modified maze and valve procedure through a port-access approach
Background: The aim of the study was to assess the feasibility and effectiveness of the irrigated radiofrequency modified maze procedure through a port-access approach during mitral valve surgery. Methods: Forty-three patients with atrial fibrillation (AF) and mitral valve disease underwent a combined procedure through a port-access approach. The indication was a history of continuous AF for more than 6 months in patients eligible for minimally invasive mitral valve surgery. Results: The incidence of early mortality was 1 patient (2.3%) and that of freedom from AF was 100% at the end of the operation (70% of patients with normal sinus rhythm 30% with a pacemaker). One patient (2.3%) required permanent pacemaker implantation after surgery. One patient (2.3%) required reoperation for bleeding. There were no reoperations for failed valve repairs. The incidences of freedom from AF were 87% and 92% at 6 and 12 months respectively. At 12 months functional capacity had improved significantly (P < .05). There were no procedure-related complications. No thromboembolic events were detected during follow-up. Conclusion: The port-access approach provided a good access for both valve surgery and the radiofrequency maze procedure. The combination of direct and videoscopic vision allowed an adequate view and led to a safe and efficient combined procedure. Short- and intermediate-term follow-up results were favorable.