Cooper Surgeons Combine Mitral Valve Repair, MAZE Procedure for Atrial Fibrillation Patients

Mitral valvular disease, both mitral stenosis and regurgitation, is frequently associated with atrial fibrillation. At the Cooper Heart Institute cardiovascular surgeons are combining mitral valve repair and surgical treatment for atrial fibrillation, to offer an effective therapy for patients presenting with both disease entities.

Surgical Intervention

The MAZE or Cox-MAZE procedure has been performed for chronic and paroxysmal atrial fibrillation since the early 1990’s. The procedure is performed by creating multiple incisions in the left and right atria. This process disrupts the abnormal electrical activity and redirects impulses to the standard conduction path along the SA node to the AV node. Clinical outcomes are generally excellent, with permanent return to normal sinus rhythm reported in 90-95% of patients.

“The procedure is very effective but involves surgery and cardiopulmonary support,” says Anthony DelRossi, M.D., chairman of Surgery and director of Cardiovascular Surgery at Cooper University Hospital.

“When anti-arrhythmic agents or percutaneous methods have failed to restore sinus rhythm, the MAZE procedure is a viable therapeutic alternative. The ideal scenario is to perform the procedure as adjunctive therapy when a concurrent surgical repair is necessary,” added Dr. DelRossi.

Short-term atrial fibrillation (three–six months) is reported in one-third to one-half of patients after the MAZE procedure. A small subset of patients may require a post-op pacemaker, as atrial fibrillation may have masked a previously undetected cardiac arrhythmia.

“Most patients report a significant reduction in symptoms such as syncope or near syncope,” says Dr. DelRossi. “In addition, a reduction in the incidence of transient ischemia or embolic events have been reported in this population.”

Minimally Invasive Procedure

The Cooper Heart Institute is currently pursuing minimal invasive technology as an alternative to the traditional MAZE procedure. “We believe this treatment offers excellent clinical outcomes, and that the patient experience would be enhanced in a minimally invasive scenario,” reports Dr. DelRossi.

For more information about the MAZE procedure, combination therapies or to refer a patient for cardiovascular surgery, please call: (856) 342-2141.