ArticleThe Journal of thoracic and cardiovascular surgery2022
Concomitant surgical ablation for atrial fibrillation is associated with increased risk of acute kidney injury but improved late survival.
Article in The Journal of thoracic and cardiovascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 32 citations in OpenAlex.
- Comorbidity phenotypes and the incidence and severity of acute kidney injury in older critically ill patients: a retrospective cohort study.BMC geriatrics · 2026Article
- The long-term outcomes of concomitant Cox-Maze IV procedure in patients with mitral valve disease and atrial fibrillation.The Journal of thoracic and cardiovascular surgery · 2025Article
- National outcomes of surgical ablation for atrial fibrillation at the time of mitral surgery.Interdisciplinary cardiovascular and thoracic surgery · 2025Article
- Biomarkers of postoperative cardiac surgery-associated acute kidney injury: Narrowing the field.JTCVS open · 2025Article
- Concomitant Surgical Ablation in Paroxysmal vs Persistent Atrial Fibrillation During Mitral Surgery.The Annals of thoracic surgery · 2025Article
- Long-term outcomes of concomitant Cox-Maze III procedure in patients with aortic valve diseases and preoperative atrial fibrillation.Journal of thoracic disease · 2025Article
- 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.Journal of arrhythmia · 2024Article
- 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- Atrial Fibrillation Management During Surgical vs Transcatheter Aortic Valve Replacement.The Annals of thoracic surgery · 2024Article
- Safety of pulsed field ablation in more than 17,000 patients with atrial fibrillation in the MANIFEST-17K study.Nature medicine · 2024Article
- Surgical ablation of atrial fibrillation is associated with improved survival compared with appendage obliteration alone: An analysis of 100,000 Medicare beneficiaries.The Journal of thoracic and cardiovascular surgery · 2024Article
- 2024 European Heart Rhythm Association/Heart Rhythm Society/Asia Pacific Heart Rhythm Society/Latin American Heart Rhythm Society expert consensus statement on catheter and surgical ablation of atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Does the maze procedure predispose to acute kidney injury?Journal of thoracic disease · 2023Article
- The maze IV operation is not always the best choice: Matching the procedure to the patient.JTCVS techniques · 2023Article
- Late results after stand-alone surgical ablation for atrial fibrillation.The Journal of thoracic and cardiovascular surgery · 2022Article
- Incidence and risk factors of acute kidney injury after maze operation in patients with rheumatic mitral valve disease.Journal of thoracic disease · 2022Article
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10 authors at 2 institutions in 1 country.
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Abstract
backgroundAcute kidney injury (AKI) after cardiac surgery remains a common complication that has been associated with increased morbidity and mortality. This study implemented Kidney Disease Improving Global Outcomes criteria to evaluate renal outcomes after concomitant surgical ablation for atrial fibrillation.
methodsPatients with a history of atrial fibrillation who underwent elective cardiac surgery at our institution from 2008 to 2018 were retrospectively reviewed. Those with preoperative renal dysfunction were excluded. Patients were classified as those who underwent concomitant Cox-Maze IV (CMP-IV) (n = 376) or no surgical ablation (n = 498). Nearest neighbor 1:1 propensity matching was conducted on fourteen covariates. AKI was evaluated by mixed effects logistic regression analysis. Long-term survival was evaluated by proportional hazards regression.
resultsPropensity matching yielded 308 patients in each group (n = 616). All preoperative variables were similar between groups. The concomitant CMP-IV group had a greater incidence of AKI: 32% (n = 99) versus 16% (n = 49), P < .001. After accounting for bypass time and nonablation operations on mixed effects analysis, concomitant CMP-IV was associated with increased risk of AKI (odds ratio, 1.89; confidence interval, 1.12-3.18; P = .017). While AKI was associated with decreased late survival (P < .001), patients who received a concomitant CMP-IV maintained superior 7-year survival to patients who received no ablation (P < .001). No patients required permanent dialysis.
conclusionsConcomitant CMP-IV was independently associated with increased risk of AKI in the acute postoperative period. However, the long-term risks of AKI were offset by the significant survival benefit of CMP-IV. Concerns regarding new-onset renal dysfunction should not prohibit recommendation of this procedure in appropriate patients.
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