Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study
Background. The maze procedure aims to eliminate atrial fibrillation (AF), restore sinus rhythm (SR) and atrial contractility. However, conflicting evidence exists regarding the extent of atrial remodelling in various techniques, which directed the focus of our study.Objectives. An atrial remodellin...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
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Ministry of Healthcare of the Russian Federation. “Kuban State Medical University”
2022-05-01
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| Series: | Кубанский научный медицинский вестник |
| Subjects: | |
| Online Access: | https://ksma.elpub.ru/jour/article/view/2739 |
| _version_ | 1797295317450752000 |
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| author | G. N. Antipov A. S. Postol S. N. Kotov M. O. Makarova Yu. A. Shneider |
| author_facet | G. N. Antipov A. S. Postol S. N. Kotov M. O. Makarova Yu. A. Shneider |
| author_sort | G. N. Antipov |
| collection | DOAJ |
| description | Background. The maze procedure aims to eliminate atrial fibrillation (AF), restore sinus rhythm (SR) and atrial contractility. However, conflicting evidence exists regarding the extent of atrial remodelling in various techniques, which directed the focus of our study.Objectives. An atrial remodelling comparison after a cut-and-sew maze-3 surgery and its biatrial cryo-maze modification using 2D echocardiography.Methods. The study is a retrospective uncontrolled interrupted two-cohort time-series trial, with patients selected by pseudorandomisation according to a normal sinus rhythm-maintaining AF surgery method. A total of 217 maze-3 and 113 cryo-maze combined cardiac interventions have been performed within 2012–2021. The interventions included valve repair, coronary artery bypass grafting and their combination. Due to differences in long-term follow-up, the cohorts were pseudorandomised to select by 50 restored vs. maintained sinus rhythm patients using a nearest-neighbour classifier coupled with logistic regression. Mean follow-up period was 6 (1–17) months. The patients had paroxysmal, persistent and longstanding persistent AF. Echocardiography values prior to and long-term post-surgery were further analysed to determine the atrial remodelling dynamics. Results. A statistically significant atrial volume reduction is evident in a long-term within-cohort comparison. Meanwhile, a statistically more pronounced remodelling is observed between cohorts after maze-3 procedure. The cohort 1 vs. 2 estimates are: mean left atrial volume 120/125 mL3 (p = 0.011), left atrial size in apical view 52/53 mm (p = 0.023), right atrial size in apical view 58/62 mm (p = 0.004), right atrial size in parasternal short axis view 43/45 mm (p = 0.004), right atrial area in apical 4-chamber view 25/28 cm2 (p = 0.007). Maintained atrial pacing patients had positive systolic atrial function recovery rates (E/A ratio increased to average 1.5) in the long-term in both comparison cohorts.Conclusion. Remodelling is biatrial after all the maze procedures compared. A more pronounced atrial volume reduction occurs after maze-3 surgery. The presence of sinus rhythm is facilitated by cardiac conduction leading to mechanical and electrical remodelling of the atria. |
| first_indexed | 2024-03-07T21:47:03Z |
| format | Article |
| id | doaj.art-0069feae05ea406cbea3aa5ff7e3daf5 |
| institution | Directory Open Access Journal |
| issn | 1608-6228 2541-9544 |
| language | Russian |
| last_indexed | 2024-03-07T21:47:03Z |
| publishDate | 2022-05-01 |
| publisher | Ministry of Healthcare of the Russian Federation. “Kuban State Medical University” |
| record_format | Article |
| series | Кубанский научный медицинский вестник |
| spelling | doaj.art-0069feae05ea406cbea3aa5ff7e3daf52024-02-25T10:57:26ZrusMinistry of Healthcare of the Russian Federation. “Kuban State Medical University”Кубанский научный медицинский вестник1608-62282541-95442022-05-01292142710.25207/1608-6228-2022-29-2-14-271305Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective studyG. N. Antipov0A. S. Postol1S. N. Kotov2M. O. Makarova3Yu. A. Shneider4Federal Centre for High Medicine TechnologiesFederal Centre for High Medicine TechnologiesFederal Centre for High Medicine TechnologiesImmanuel Kant Baltic Federal UniversityFederal Centre for High Medicine TechnologiesBackground. The maze procedure aims to eliminate atrial fibrillation (AF), restore sinus rhythm (SR) and atrial contractility. However, conflicting evidence exists regarding the extent of atrial remodelling in various techniques, which directed the focus of our study.Objectives. An atrial remodelling comparison after a cut-and-sew maze-3 surgery and its biatrial cryo-maze modification using 2D echocardiography.Methods. The study is a retrospective uncontrolled interrupted two-cohort time-series trial, with patients selected by pseudorandomisation according to a normal sinus rhythm-maintaining AF surgery method. A total of 217 maze-3 and 113 cryo-maze combined cardiac interventions have been performed within 2012–2021. The interventions included valve repair, coronary artery bypass grafting and their combination. Due to differences in long-term follow-up, the cohorts were pseudorandomised to select by 50 restored vs. maintained sinus rhythm patients using a nearest-neighbour classifier coupled with logistic regression. Mean follow-up period was 6 (1–17) months. The patients had paroxysmal, persistent and longstanding persistent AF. Echocardiography values prior to and long-term post-surgery were further analysed to determine the atrial remodelling dynamics. Results. A statistically significant atrial volume reduction is evident in a long-term within-cohort comparison. Meanwhile, a statistically more pronounced remodelling is observed between cohorts after maze-3 procedure. The cohort 1 vs. 2 estimates are: mean left atrial volume 120/125 mL3 (p = 0.011), left atrial size in apical view 52/53 mm (p = 0.023), right atrial size in apical view 58/62 mm (p = 0.004), right atrial size in parasternal short axis view 43/45 mm (p = 0.004), right atrial area in apical 4-chamber view 25/28 cm2 (p = 0.007). Maintained atrial pacing patients had positive systolic atrial function recovery rates (E/A ratio increased to average 1.5) in the long-term in both comparison cohorts.Conclusion. Remodelling is biatrial after all the maze procedures compared. A more pronounced atrial volume reduction occurs after maze-3 surgery. The presence of sinus rhythm is facilitated by cardiac conduction leading to mechanical and electrical remodelling of the atria.https://ksma.elpub.ru/jour/article/view/2739atrial fibrillationmaze surgeryatrial remodelling |
| spellingShingle | G. N. Antipov A. S. Postol S. N. Kotov M. O. Makarova Yu. A. Shneider Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study Кубанский научный медицинский вестник atrial fibrillation maze surgery atrial remodelling |
| title | Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study |
| title_full | Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study |
| title_fullStr | Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study |
| title_full_unstemmed | Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study |
| title_short | Atrial remodelling comparison after maze-3 and cryo-maze procedures in combined cardiac interventions: a retrospective study |
| title_sort | atrial remodelling comparison after maze 3 and cryo maze procedures in combined cardiac interventions a retrospective study |
| topic | atrial fibrillation maze surgery atrial remodelling |
| url | https://ksma.elpub.ru/jour/article/view/2739 |
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