“There are many cases where the dose of anticoagulants was reduced or stopped after Maze’s operation.”
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Atrial fibrillation surgery is a labyrinth surgery that corrects the path of the electrical signals that make the heart beat. In this operation, electrical signals generated from the sinus node located above the right atrium move and the heart beats regularly.
Atrial fibrillation, where the heart beats irregularly, occurs when electrical signals are generated in a disorganized manner.
However, a study has found that patients with atrial fibrillation with Sumo valve disease have a better prognosis if they undergo Maze surgery at the same time as the valve surgery.
A joint research team led by Seung-Hyun Lee from the Department of Cardiovascular Surgery at Resignation Hospital, Hee-Joong Kim from the Department of Thoracic Surgery at Korea University Anam Hospital, and Kyung-Do Han, Professor at the Department of Information, Statistics, Actuarial and Actuarial Sciences at Soongsil University. The risk of bleeding is reduced, they say.
Atrial fibrillation, a type of arrhythmia, is a typical complication of mitral valve disease. The mitral valve pumps blood from the left atrium into the left ventricle, and when the valve narrows or malfunctions, the left atrial pressure rises and the left atrium expands. As the atrial size increases, the risk of atrial fibrillation can increase.
Because of the possibility that taking an anticoagulant after valve surgery can prevent stroke, a complication of atrial fibrillation, even without a corn operation, many actual corn operations have not been performed. The Korean Arrhythmia Society has not yet issued a surgical recommendation.
Meanwhile, there have been several studies on the effect of performing mitral valve surgery and corn surgery, but most of them were limited to one institution or a short follow-up period.
Provided by Dismissal Hospitals
The research team compared the prognosis of patients who had mitral valve surgery and corn surgery with those who had only valve surgery to find out the effects of accompanying corn surgery.
Firstly, a statistical analysis was carried out on all 9,501 patients with atrial fibrillation and mitral valve surgery registered with the National Health Insurance Corporation. Among them, the number of patients who underwent labyrinth surgery was 5,508, and the labyrinth surgery rate was not high at 57%.
Next, a study was conducted on 3376 pairs of maze surgery and control groups by propensity score matching, which compares patients with similar characteristics in pairs.
As a result, the mortality rate in the maze surgery group was 3.53 per 100 patients, which was 9.2% lower than the rate in the control group (4.45 patients). The incidence of ischemic stroke was 4.8% lower in the surgical group (1.77%) than in the control group (2.25%). The incidence of ‘bleeding events’ in the hospital for bleeding was 1.39% and 1.87%, respectively. The incidence rates of ‘complex events’ combining the three events were 6.14% and 7.75%.
In many cases, the use of the anticoagulant warfarin was reduced or stopped after the Maze operation. One year after surgery, the rate of warfarin use in the corn surgery group was 15%, which was lower than the rate of the control group (19%).
Professor Lee Seung-hyun said, “Although there has been a small-scale investigation on the combination of valve surgery and maze surgery, this study is the first to examine all the data from the National Health Insurance Corporation that will,” he said.
The results of this study were published in the official journal ‘Heart Rhythm’ of the American Academy of Cardiac Arrhythmias.
Lee Seung-gu, online news reporter lee_owl@segye.com
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