Comparative Outcomes of the MAZE Procedure in Mitral Valve Surgery versus Other Cardiac Interventions

Background: The MAZE procedure, designed to address atrial fibrillation, is often performed with other cardiac surgeries. This study compares outcomes in patients undergoing MAZE with mitral valve interventions (mitral group, n=473) to those with other cardiac surgeries (non-mitral group, n=239).

Methods: A retrospective cohort of 712 patients were analyzed. Key outcomes included hospital mortality, overall mortality, postoperative atrial fibrillation, and baseline characteristics. Statistical analyses included t-tests and chi-squared tests.

Results: Regarding Baseline Characteristics, the non-mitral group was older (66.3 ± 10.2 vs. 64.5 ± 10.2 years, p=0.025) and had more male patients (72.8% vs. 47.4%, p<0.001). Comorbidities such as diabetes (28.8% vs. 15.6%, p<0.001), hypertension (70.2% vs. 59.5%, p=0.007), hyperlipidemia (68.2% vs. 48.9%, p<0.001), and obesity (48.1% vs. 24%, p<0.001) were more prevalent in the non-mitral group. These differences reflect the inclusion of CABG patients in the non-mitral group.
There was no significant difference in hospital mortality (non-mitral: 1.7%, mitral: 0.4%, p=0.102) or overall mortality (non-mitral: 32.2%, mitral: 26.0%, p=0.098).

As to Postoperative Atrial Fibrillation: Freedom from AF right after surgery was 68.8% in the mitral group and 74.2% in the non-mitral group, p=0.159. On long-term follow-up, the rates were also similar between groups, with improvement in both – 89% in the mitral group and 87.1% in the non-mitral group, p=0.633, with an average follow-up time of 61.18 and 37.5, respectively.

Conclusions: Patients undergoing the MAZE procedure with mitral valve interventions have comparable hospital and overall mortality rates to those undergoing other cardiac procedures. Despite the expectation of higher rates of recurrent AF in the non-mitral group, atrial fibrillation rates were not elevated, suggesting a potential benefit of the MAZE procedure in all types of concomitant surgeries.