Kukulela, Nangamso2020-03-122020-03-122018-02-11https://hdl.handle.net/10539/29136research report submitted to the Faculty of Health Sciences, University of Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the Degree of Masters in Medicine. Johannesburg,2018Objectives: Outcomes data on the efficacy of the Cox-maze procedure for the treatment of valvular atrial fibrillation mostly originates from developed countries, with a paucity of data from the developing world. The primary objective of this study was to determine the outcomes of the Cox-maze procedure for valvular atrial fibrillation (AF) in a public tertiary academic centre in Johannesburg, South Africa. Methods: We retrospectively reviewed inpatient and outpatient records of adult patients who underwent the Cox-maze procedure for valvular atrial fibrillation from January 2000 to December 2015. The study data collected included the primary indications for cardiac surgery, perioperative complications and follow-up outcomes data on the successful treatment of AF and restoration of sinus rhythm. Results: We reviewed 144 patient records of which 98 (68.1%) were females. The mean age was 45.0 (SD: 12.4) years. Before surgery, 141 participants had a documented NYHA functional class. Of these, 117 (83.0%) participants were in NYHA class III with a mean ejection fraction of 55% (SD: 12.5). Rheumatic mitral stenosis was the primary indication for surgery in 73 (50.7%) participants. Immediately after surgery, sinus rhythm was restored in 106 (74%) patients. After a mean duration of 5.6 years (SD: 3.3), 104 patients had a documented rhythm. Of these, 81 (76.4%) remained in sinus rhythm. On multivariable analysis, none of the study variables could predict persistent atrial fibrillation Conclusions: Our findings suggest that the Cox-maze procedure is effective in the management of valvular atrial fibrillation in symptomatic patients undergoing open heart surgery.enThesis