Các yếu tố liên quan đến kết quả của phẫu thuật Maze trong phẫu thuật thay van hai lá

Study on all patients with simple mitral valve disease and atrial fibrillation who were assigned to have mitral valve replacement surgery with Maze IV surgery from 01/2022 to 07/2023. Retrospective and prospective, non­controlled studies. Results: 51 patients (17 men, 34 women, mean age 55.22 ± 9.13) were eligible to participate in the study. The rate of sinus rhythm restoration at the time of discharge - 3 months - 6 months after surgery was 56.9% - 90.2% - 94.1%, respectively. Preoperative echocardiographic parameters have no predictive value in predicting the likelihood of sinus rhythm re-establishment, while postoperative parameters have high prognostic value. Using ROC curve analysis, we provide cut-off thresholds with predictive value: postoperative left atrial diameter < 42.5 mm (AUC = 0.798, sensitivity 75%, specificity) 63.8%, p=0.05), LA diameter at 6 months follow­up < 45.5 mm (AUC = 0.929, sensitivity 75%, specificity 88.6%, p < 0.01), left atrial volume index (LAVi) re-examination at 6 months <62 ml/m2 (AUC = 0.827, sensitivity 75%, specificity 84.6%, p<0.05), LAVi re-examination at 6 months <60.5 ml/m2 (AUC = 0.867, sensitivity 67%, specificity 91.4%, p<0.05) increased the success rate of sinus cardioversion. Conclusion: Maze surgery has a high success rate in patients who are indicated for mitral valve replacement surgery. Using ROC curve analysis, the parameters on echocardiography at 6 months after surgery: LA diameter < 45.5 mm, LAVi < 60.5 ml/m2 are factors that increase the success rate of ablation of atrial fibrillation and sinus cardioversion.