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Eur J Cardiothorac Surg 2002;22:822-824
© 2002 Elsevier Science NL

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The value of caval division in the maze procedure with valve surgery

Department of Cardio-Thoracic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan

Received 14 March 2002; received in revised form 5 August 2002; accepted 6 August 2002.

* Corresponding author. Tel.: +81-52-744-2376; fax: +81-52-744-2383
e-mail: smizutan{at}med.nagoya-u.ac.jp

Operative predictors for successful elimination of atrial fibrillation (AF) following the maze procedure are not yet known. We have often divided the superior vena cava (SVC) during the maze procedure, not to eliminate AF but in order to explore the mitral valve. However, in multivariate analysis of 79 patients, the division of SVC, as well as the duration of AF, was found to be the strongest predictor of AF elimination. The explanation of this observation is not clear, but denervation of the cardiac autonomic nervous system or the existence of paroxysmal AF originating from the SVC could be involved.

Key Words: Atrial fibrillation • Arrhythmia • Maze procedure