Long-Term Outcomes of Mechanical Valve Replacement in Patients with Atrial Fibrillation: Impact of the Maze Procedure

American Heart Association: Joon Bum Kim1; Joon Suk Moon2; Sung-Cheol Yun2; Wan Kee Kim1; Sung-Ho Jung1; Suk Jung Choo1; Hyun Song3; Cheol Hyun Chung1; Jae Won Lee1*, March 28, 2012.

Background—The long-term benefits of the Maze procedure in patients with chronic atrial fibrillation (AF) undergoing mechanical valve replacement who already require lifelong anticoagulation remain unclear.

Methods and Results—We evaluated adverse outcomes (death; thromboembolic events; composite of death, heart failure or valve-related complications) in 569 patients with AF-associated valvular heart disease who underwent mechanical valve replacement with (n=317) or without (n=252) a concomitant Maze procedure between 1999 and 2010. After adjustment for differences in baseline risk profiles, patients who had undergone the Maze procedure were at similar risks of death (hazard ratio 1.15, 95% CI 0.65-2.03, P=0.63) and the composite outcomes (hazard ratio 0.82, 95% CI 0.50-1.34, P=0.42), but were at a significantly lower risk of thromboembolic events (hazard ratio 0.29, 95% CI 0.12-0.73, P=0.008) than those who underwent valve replacement alone at a median follow-up of 63.6 months (range 0.2-149.9 months).  Read More