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J.Jpn. Surg. Soc.. 115(5): 266-269, 2014

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Department of Cardiovascular Surgery, Nippon Medical School, Tokyo, Japan

Yosuke Ishii

It is important to explain the benefits and risks of surgery thoroughly to patients and their families. This paper describes the benefits and risks of the Maze procedure for atrial fibrillation (AF). The purpose of the Maze procedure is the restoration of sinus rhythm from AF, recovery of cardiac function by atrial contraction, and prevention of stroke. The AF cure ratio is 70-90% after the Maze procedure. It was reported that atrial function improves due to atrial contraction after surgery, and the risk of a stroke is reduced to about 2-4 events per 1,000 patients per year after surgery. On the other hand, bleeding is the most common complication after the Maze procedure. The use of alternative surgical ablation devices instead of the cut-and-sew technique decreases the risk of bleeding. Pacemakers are implanted in 5-10% of patients after the Maze procedure due to sick sinus syndrome. In approximately 40% of patients, transient AF occurs during the first month after surgery. However, the addition of the Maze procedure to cardiac surgery for structural heart disease does not increase the surgical risk.

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