| Atrial fibrillation (Af) is a usually cardiac arrhythmias. The present surgery treatments treating atrial fibrillation are based on the Maze Procedure (MP). For the limitimg of the MP, Nitta invented a new approach-Radial Incision Approach (RIA) to treat Af. He cut the atrial into several parts from Sinus node (SN) to atrial-ventricle node, based on the running of atrium artery. He thinks this radial incision do not isolated any part of the atrial.,so all the part of the atrial can constrict well after the operation. He thinks the effect in treating Af is as good as MP, but at the same time, the RIA overcome the shortcoming of MP. In china, we firstly used this approach to treat atrial fibrillation, and compared the effects of RIA and MP in treating Af.Method:Nine patients with rheumatic heart disease (RHD) and Af were treated with replaced heart valve and RIA from October 2001 to June 2002. The patients including 5 men and 4 women, aged from 19 to 52years (average 41.7 years). At the same time, 12 RHD patients with Af were only replaced mitral valve without treating Af. 10 RHD patients replaced valves treating Af with MP from 1997 to 2000.All the patients were observed carefully in perioperative. The general dates of the three groups before the operation were analysed, such as: ages, sex, duration of Af, C/T rate, the heart rate variety after sports, V1f wave, diameter of left atrial, ejection fraction (EF)of left ventrical.The dates of the three groups in the operation were analysed also, such as: duration of aortic cross clamp (ACC), cardiopulmonary bypass (CPB).The dates of the three groups after the operation were analysed too, such as: the amount of draining after the operation, sinu rhythm at time of the operation day, a week and a month late, and mitral A wave and EF of the echocardiography a month late.Statistic method: count data were treated in the revised x2 test; measurement data were treated in the t test. Using statistics software of SPSS 10.0 to treat the data. P representative statistics significance. P<0.05 show statistics difference having marked significance.Results:The general dates of the three groups before the operation are comparatively (P>0.05, differences no marked significance). It is means the illness of the three group patients are almost the same. Every patient's heart rate can increase evidencely after sport, so the functionof the patient's SN is good.The duration of CPB and ACC of RIA as same as MP, longer than the group of replaced mitral valve only. It is means the difficulty of the two technique are the same, it is more difficulty than the group of replaced mitral valve only.Replaced mitral valve only can not cure Af, the effect of RIA and MP treating Af are the same. All the patients treated with amiodarone for 3 months after the operation at least. A month after operation, Af recurrented in the all of 12 patients replaced mitral valve only; all of 9 patients performed RIA are still sinus rhythm; 9 of 10 patients performed MP are still sinus rhythm too. For the P wave in the ECG never die down after the RIA operation, but MP do. Some sinus rhythm after MP become node rhythm some time later, it indirectly mean the function of sinus node after RIA are better than MP.The EF of left ventrical of three groups almost the same 1 month later of the operation, it is means the effect of the three techniques in the left ventricle are the same. The mitral A wave can not measure after replaced mitral valve only, but RIA and MP can. The mitral A wave after RIA are higher than after MP. It is meams the left atrial's contraction after RIA is better than MP.The amount of draining after RIA is as much as the group of replaced mitral valve only, but less than MP. The complication after RIA as much as MP, but more than the group of replaced mitrial valve only.conclusion:1 :The duration of CPB and ACC of RIA as same as MP, longer than replaced mitral valve only.2:The amount of draining after RIA is as much as replaced mitral...
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