RIGHT-SIDED MAZE PROCEDURE FOR RIGHT ATRIAL ARRHYTHMIAS IN CONGENITALHEART-DISEASE

Background. Atrial fibrillation and nutter, commonly associated with c ongenital heart anomalies that cause right atrial dilatation, may caus e significant morbidity and reduction of quality of life, even after s urgical repair of the anomalies. Methods. In an effort to reduce the i ncidence of atrial tachyarrhythmias after repair of right-sided congen ital heart disease, we performed a concomitant right-sided maze proced ure. Results. Eighteen patients with paroxysmal atrial fibrillation or nutter (n = 12) or chronic atrial fibrillation or nutter (n = 6) aged 10.9 to 68.4 years (mean 34.9 years) underwent a right-sided maze in association with repair of Ebstein's anomaly (n = 15), congenital tric uspid insufficiency (n = 2), and isolated atrial septal defect (n = 1) . There were no early deaths, reoperations, or complete heart block. D ischarge rhythm was sinus (n = 16) or junctional (n = 2). Follow-up wa s complete in all 18 patients and ranged from 3.1 to 17.2 months (mean 8.1 months); all are in New York Heart Association class I. Early pos toperative arrhythmias developed in 3 patients (all were converted to sinus rhythm by antiarrhythmic drugs). There were no late deaths or re operations. Conclusions. The inclusion of a right-sided maze procedure with cardiac repair in patients having congenital heart anomalies tha t cause right atrial dilatation and associated atrial tachyarrhythmias is effective in eliminating or reducing the incidence of those arrhyt hmias. (C) 1998 by The Society of Thoracic Surgeons.