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The Journal of Thoracic and Cardiovascular Surgery, Vol 105, 1077-1087, Copyright © 1993 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
PM McCarthy, LW Castle, JD Maloney, RG Trohman, TW Simmons, RD White, AL Klein and DM Cosgrove 3d
From January 1991 until May 1992, a total of 14 patients (mean age 48
years) underwent the maze procedure for refractory atrial fibrillation
(mean duration, 7 years; mean number of antiarrhythmic medications, six).
Three patients had had embolic events, one patient had had a cardiac arrest
from flecainide, one had pulmonary fibrosis from amiodarone, and six of ten
who were employed were temporarily disabled. Two patients underwent
successful mitral valve repair in which the maze procedure was added as a
secondary goal of the operation. Postoperative fluid retention was a
problem in five patients (36%). Six patients (43%) were temporarily treated
with an antiarrhythmic medication. Two patients (14%) with preoperative
sick sinus syndrome required pacemakers. One patient was discharged from
the hospital but died suddenly less than 1 month after the operation (7%
operative mortality) of hyperkalemia caused by acute renal failure. All
patients beyond 3 postoperative months (100% "cure") are receiving no
antiarrhythmic medications, have sinus rhythm, or have p-wave tracking with
ventricular pacing. Atrial contraction has been documented by cinegraphic
magnetic resonance imaging studies and by Doppler echocardiography
performed when sinus rhythm had resumed. The maze procedure is an extensive
operation but is indicated for selected patients who have the severe
sequelae of atrial fibrillation.
ARTICLES
Initial experience with the maze procedure for atrial fibrillation
Department of Thoracic and Cardiovascular Surgery, Cleveland Clinic Foundation, Ohio 44195.
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F. Yoshihara, T. Nishikimi, Y. Sasako, J. Kobayashi, Y. Kosakai, R. Hattori, T. Horio, S. Kitamura, H. Matsuo, T. Ohe, et al. PRESERVATION OF THE RIGHT ATRIAL APPENDAGE IMPROVES REDUCED PLASMA ATRIAL NATRIURETIC PEPTIDE LEVELS AFTER THE MAZE PROCEDURE J. Thorac. Cardiovasc. Surg., April 1, 2000; 119(4): 790 - 794. [Abstract] [Full Text] [PDF]
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J. Kobayashi, Y. Kosakai, K. Nakano, Y. Sasako, K. Eishi, and F. Yamamoto Improved success rate of the maze procedure in mitral valve disease by new criteria for patients' selection Eur. J. Cardiothorac. Surg., March 1, 1998; 13(3): 247 - 252. [Abstract] [Full Text] [PDF]
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K.-B. Kim, C.-H. Lee, C.-H. Kim, Y.-J. Cha, S. :, and J. L. Cox Effect of the Cox maze procedure on the secretion of atrial natriuretic peptide J. Thorac. Cardiovasc. Surg., January 1, 1998; 115(1): 139 - 147. [Abstract] [Full Text] [PDF]
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J. Tamai, Y. Kosakai, T. Yoshioka, E. Ohnishi, H. Takaki, Y. Okano, and Y. Kawashima Delayed Improvement in Exercise Capacity With Restoration of Sinoatrial Node Response in Patients After Combined Treatment With Surgical Repair for Organic Heart Disease and the Maze Procedure for Atrial Fibrillation Circulation, May 1, 1995; 91(9): 2392 - 2399. [Abstract] [Full Text]
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