The Clinical Outcome of Maze Procedure in Atrial Functional Mitral Regurgitation

Abstract

Atrial functional mitral regurgitation (AFMR) is a newly discovered condition associated with long-standing atrial fibrillation (AF). This retrospective study analyzed the outcomes of the maze procedure and mitral regurgitation surgery in patients with AFMR and compared them with those in patients without AFMR. Patients who underwent the maze procedure at a single center were included (July 2012–August 2021). After excluding patients aged <18 years and those with infective endocarditis, 36 patients with AFMR (AFMR group) and 248 without AFMR (non-AFMR group) were enrolled in the study. The outcomes were compared using propensity score matching (PSM). After PSM, there were 36 patients in each group. The rates of freedom from AF at 1, 3, and 5 years postoperatively were 64.5%, 62.5%, and 60.0%, respectively, in the AFMR group, and were not significantly different from those in the non-AFMR group (p = 0.07). However, significantly more patients with AFMR exhibited junctional rhythm after the maze procedure than those without AFMR (p = 0.001) and significantly more underwent permanent pacemaker insertion in the AFMR group than in the non-AFMR group (p = 0.021). The groups demonstrated no significant differences in cardiac operation results. Patients with AFMR required close observation for sinus nodal dysfunction with bradycardia after the maze procedure. However, the results of cardiac surgery, including mitral valve repair, were comparable to those in patients without AFMR.