IJCEMR
Clinical Analysis and Early Follow-up Results of Total Thoracoscopic Mitral Valve Surgery Combined with Cox-Maze IV Ablation in 39 Cases
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Abstract
Objective: By retrospectively analyzing clinical data of 39 patients who underwent a combined total thoracoscopic mitral valve surgery and MAZE IV ablation at the Cardiovascular Surgery Department of Leshan People's Hospital from May 2021 to December 2023, to summarize the surgical experience and report the early follow-up results. Methods: The clinical data of 39 pa-tients who underwent a combined total thoracoscopic mitral valve surgery and MAZE IV ablation at the Cardiovascular Surgery Department of Leshan People's Hospital from May 2021 to September 2023 were retrospectively analyzed. There were 11 males and 28 females, with an average age of 60.5±7.3 years. Results: Mitral valve reshaping was performed on 12 patients, and mitral valve replacement was performed on 27 patients. Four patients underwent conversion to open surgery, and 2 patients underwent conversion to valve replacement. Two patients underwent non-planned surgery to stop bleeding. The average hospital stay was 27.5±18.6 days, the surgical time was 467.1±120.2 minutes, the extracorporeal circulation time was 268.3±64.5 minutes, and the cardiopulmonary bypass time was 200.7±36.8 minutes. There were 2 death cases, including 1 patient who died of sudden ventricular fibrillation after surgery and 1 patient who died of intraoperative hemorrhage after intubation. There was a significant improvement in left ventricular end-diastolic diameter and EF before and after surgery. All patients were followed up, and 2 were lost to follow-up. The turnaround rates at 3 months, 6 months, and 1 year were 83.4%, 83.8%, and 75.7%, respectively. There were significant differences between group 1 (the first 20 cases) and group 2 (the last 19 cases) in preoperative EF value and incidence of surgical complications. Although the time of operation (489.1±142.7 vs 443.9±89.0), the time of cardiopulmonary bypass (271.5±84.2 vs 265.0±31.7), the time of occlusion (203.0±25.3 vs 198.5±45.7), and the time of mechanical ventilation (72.5±109.8 vs 52.4±82.0), ICU stays time (123.9±138.8 vs 119.5±157.7), 1-year atrial fibrillation recurrence (15.4% vs 7.7%), and surgical outcome (5.1% vs 0%) were not significantly different in group 2 compared with group 1. Conclusions: Video-assisted thoracoscopic mitral valve surgery with simultaneous Maze IV ablation is a minimally invasive, safe, feasible, and effective procedure. Careful cannulation is required during the operation, and close monitoring and prevention of complications are needed during the perioperative period. After the learning curve, the surgeon can reduce the operation time and complication rate.
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How to cite this paper
Clinical Analysis and Early Follow-up Results of Total Thoracoscopic Mitral Valve Surgery Combined with Cox-Maze IV Ablation in 39 Cases
How to cite this paper: Jialin He, Jing Chen, Bo Zheng, Xuanyi Hu, Fei Zhao. (2025) Clinical Analysis and Early Follow-up Results of Total Thoracoscopic Mitral Valve Surgery Combined with Cox-Maze IV Ablation in 39 Cases. International Journal of Clinical and Experimental Medicine Research, 9(1), 44-50.
DOI: http://dx.doi.org/10.26855/ijcemr.2025.01.009
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