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J Thorac Cardiovasc Surg 1995;110:485-495
© 1995 Mosby, Inc.

SURGERY FOR ACQUIRED HEART DISEASE

MODIFICATION OF THE MAZE PROCEDURE FOR ATRIAL FLUTTER AND ATRIAL FIBRILLATIONII. Surgical technique of the maze III procedure

James L. Cox, MD, Robert D. B. Jaquiss, MD, Richard B. Schuessler, PhD, John P. Boineau, MD


St. Louis, Mo.

Supported by National Institutes of Health grant Nos. RO1 HL32257 and RO1 HL33722.

Received for publication Sept. 27, 1994. Accepted for publication Feb. 6, 1995. Address for reprints: James L. Cox, MD, Evarts A. Graham Professor of Surgery, Vice-Chairman, Department of Surgery, Chief, Division of Cardiothoracic Surgery, Suite 3108, Queeny Tower, One Barnes Hospital Plaza, St. Louis, MO 63110.

Abstract

The operative technique of the maze III procedure for the treatment of patients with medically refractory atrial flutter and atrial fibrillation is described in a sequential fashion. The accompanying diagrams of the procedure are illustrated from the view of the operating surgeon. (J THORACCARDIOVASCSURG1995;110:485-95)




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Guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology
Eur. Heart J., October 2, 2001; 22(20): 1852 - 1923.
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 J Am Coll CardiolHome page
V. Fuster, L. E. Ryden, R. W. Asinger, D. S. Cannom, H. J. Crijns, R. L. Frye, J. L. Halperin, G. N. Kay, W. W. Klein, S. Levy, et al.
ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary: A Report of the American College of Cardiology/ American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology
J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1231 - 1265.
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 J Am Coll CardiolHome page
V. Fuster, L. E. Ryden, R. W. Asinger, D. S. Cannom, H. J. Crijns, R. L. Frye, J. L. Halperin, G. N. Kay, W. W. Klein, S. Levy, et al.
ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology
J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1266 - 1266.
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 Ann. Thorac. Surg.Home page
K. Khargi, T. Deneke, H. Haardt, B. Lemke, P. Grewe, K.-M. Muller, and A. Laczkovics
Saline-irrigated, cooled-tip radiofrequency ablation is an effective technique to perform the Maze procedure
Ann. Thorac. Surg., September 1, 2001; 72(3): S1090 - 1095.
[Abstract] [Full Text] [PDF]

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 Ann. Thorac. Surg.Home page
J. S. Raman, S. Seevanayagam, M. Storer, and J. M. Power
Combined endocardial and epicardial radiofrequency ablation of right and left atria in the treatment of atrial fibrillation
Ann. Thorac. Surg., September 1, 2001; 72(3): S1096 - 1099.
[Abstract] [Full Text] [PDF]

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 J. Thorac. Cardiovasc. Surg.Home page
J. L. Cox
Intraoperative options for treating atrial fibrillation associated with mitral valve disease
J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 212 - 215.
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 J. Thorac. Cardiovasc. Surg.Home page
H. T. Sie, W. P. Beukema, A. R. R. Misier, A. Elvan, J. J. Ennema, M. M.P. Haalebos, and H. J.J. Wellens
Radiofrequency modified maze in patients with atrial fibrillation undergoing concomitant cardiac surgery
J. Thorac. Cardiovasc. Surg., August 1, 2001; 122(2): 249 - 256.
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 Eur. J. Cardiothorac. Surg.Home page
H. T. Sie, W. P. Beukema, A. R. Ramdat Misier, A. Elvan, J. J. Ennema, and H. J.J. Wellens
The radiofrequency modified maze procedure. A less invasive surgical approach to atrial fibrillation during open-heart surgery
Eur. J. Cardiothorac. Surg., April 1, 2001; 19(4): 443 - 447.
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 Ann. Thorac. Surg.Home page
K.-B. Kim, J.-H. Huh, C. H. Kang, H. Ahn, and D.-W. Sohn
Modifications of the Cox-Maze III procedure
Ann. Thorac. Surg., March 1, 2001; 71(3): 816 - 822.
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 Ann. Thorac. Surg.Home page
K. Imai, T. Sueda, K. Orihashi, M. Watari, and Y. Matsuura
Clinical analysis of results of a simple left atrial procedure for chronic atrial fibrillation
Ann. Thorac. Surg., February 1, 2001; 71(2): 577 - 581.
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 Ann. Thorac. Surg.Home page
R. C. Millar, J. M. Arcidi Jr, and P. J.M. Alison
The maze III procedure for atrial fibrillation: should the indications be expanded?
Ann. Thorac. Surg., November 1, 2000; 70(5): 1580 - 1586.
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 Eur. J. Cardiothorac. Surg.Home page
J. Melo, P. Adragao, J. Neves, M. Ferreira, A. Timoteo, T. Santiago, R. Ribeiras, and M. Canada
Endocardial and epicardial radiofrequency ablation in the treatment of atrial fibrillation with a new intra-operative device
Eur. J. Cardiothorac. Surg., August 1, 2000; 18(2): 182 - 186.
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 J Am Coll CardiolHome page
F. Gaita, R. Gallotti, L. Calo, E. Manasse, R. Riccardi, L. Garberoglio, F. Nicolini, M. Scaglione, P. Di Donna, D. Caponi, et al.
Limited posterior left atrial cryoablation in patients with chronic atrial fibrillation undergoing valvular heart surgery
J. Am. Coll. Cardiol., July 1, 2000; 36(1): 159 - 166.
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 Eur. J. Cardiothorac. Surg.Home page
S. Benussi, C. Pappone, S. Nascimbene, G. Oreto, A. Caldarola, P. L. Stefano, V. Casati, and O. Alfieri
A simple way to treat chronic atrial fibrillation during mitral valve surgery: the epicardial radiofrequency approach
Eur. J. Cardiothorac. Surg., May 1, 2000; 17(5): 524 - 529.
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 Ann. Thorac. Surg.Home page
C. B. Overgaard, D. A. Harrison, S. C. Siu, W. G. Williams, G. D. Webb, and L. Harris
Outcome of previous tricuspid valve operation and arrhythmias in adult patients with congenital heart disease
Ann. Thorac. Surg., December 1, 1999; 68(6): 2158 - 2163.
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 J. Thorac. Cardiovasc. Surg.Home page
J. L. Cox, N. Ad, and T. Palazzo
IMPACT OF THE MAZE PROCEDURE ON THE STROKE RATE IN PATIENTS WITH ATRIAL FIBRILLATION
J. Thorac. Cardiovasc. Surg., November 1, 1999; 118(5): 833 - 840.
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 J. Thorac. Cardiovasc. Surg.Home page
N. Handa, H. V. Schaff, J. J. Morris, B. J. Anderson, S. L. Kopecky, and M. Enriquez-Sarano
OUTCOME OF VALVE REPAIR AND THE COX MAZE PROCEDURE FOR MITRAL REGURGITATION AND ASSOCIATED ATRIAL FIBRILLATION
J. Thorac. Cardiovasc. Surg., October 1, 1999; 118(4): 628 - 635.
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 Ann. Thorac. Surg.Home page
K.-B. Kim, K. R. Cho, D.-W. Sohn, H. Ahn, and J. R. Rho
The Cox-Maze III procedure for atrial fibrillation associated with rheumatic mitral valve disease
Ann. Thorac. Surg., September 1, 1999; 68(3): 799 - 803.
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 Ann. Thorac. Surg.Home page
T. Nitta, Y. Ishii, H. Ogasawara, S. Sakamoto, Y. Miyagi, K. Yamada, S. Kanno, and S. Tanaka
Initial experience with the radial incision approach for atrial fibrillation
Ann. Thorac. Surg., September 1, 1999; 68(3): 805 - 810.
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 J. Thorac. Cardiovasc. Surg.Home page
M. Pasic, M. Musci, H. Siniawski, O. Grauhan, B. Edelmann, T. Tedoriya, Y. Weng, and R. Hetzer
THE COX MAZE III PROCEDURE: PARALLEL NORMALIZATION OF SINUS NODE DYSFUNCTION, IMPROVEMENT OF ATRIAL FUNCTION, AND RECOVERY OF THE CARDIAC AUTONOMIC NERVOUS SYSTEM
J. Thorac. Cardiovasc. Surg., August 1, 1999; 118(2): 287 - 296.
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 Eur. J. Cardiothorac. Surg.Home page
J. Melo, P. Adragao, J. Neves, M. M. Ferreira, M. M. Pinto, M. J. Rebocho, L. Parreira, and T. Ramos
Surgery for atrial fibrillation using radiofrequency catheter ablation: assessment of results at one year
Eur. J. Cardiothorac. Surg., June 1, 1999; 15(6): 851 - 855.
[Abstract] [Full Text] [PDF]

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 Ann. Thorac. Surg.Home page
M. Pasic, M. Musci, B. Edelmann, H. Siniawski, P. Bergs, and R. Hetzer
Identification of P waves after the Cox-maze procedure: significance of right precordial leads V3R through V6R
Ann. Thorac. Surg., May 1, 1999; 67(5): 1292 - 1294.
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 NEJMHome page
M. A. Gatzoulis, M. A. Freeman, S. C. Siu, G. D. Webb, and L. Harris
Atrial Arrhythmia after Surgical Closure of Atrial Septal Defects in Adults
N. Engl. J. Med., March 18, 1999; 340(11): 839 - 846.
[Abstract] [Full Text] [PDF]

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 Ann. Thorac. Surg.Home page
T. Nitta, R. Lee, H. Watanabe, K. M. Harris, J. M. Erikson, R. B. Schuessler, J. P. Boineau, and J. L. Cox
Radial approach: a new concept in surgical treatment for atrial fibrillation. II. Electrophysiologic effects and atrial contribution to ventricular filling
Ann. Thorac. Surg., January 1, 1999; 67(1): 36 - 50.
[Abstract] [Full Text] [PDF]

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 EuropaceHome page
M. Holm, R. Johansson, B. Smideberg, C. Luhrs, and S.B. Olsson
Effect of cardiac exposure by median sternotomy on atrial fibrillation cycle length
Europace, January 1, 1999; 1(4): 248 - 257.
[Abstract] [PDF]

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 Ann. Thorac. Surg.Home page
S. M. Marianeschi, D. B. McElhinney, V. M. Reddy, N. H. Silverman, and F. L. Hanley
Alternative approach to the repair of Ebstein's malformation: intracardiac repair with ventricular unloading
Ann. Thorac. Surg., November 1, 1998; 66(5): 1546 - 1550.
[Abstract] [Full Text] [PDF]

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 CirculationHome page
L. M. Epstein, M. A. Mitchell, T. W. Smith, and D. E. Haines
Comparative Study of Fluoroscopy and Intracardiac Echocardiographic Guidance for the Creation of Linear Atrial Lesions
Circulation, October 27, 1998; 98(17): 1796 - 1801.
[Abstract] [Full Text] [PDF]

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 J Am Coll CardiolHome page
M. Pasic, M. Musci, H. Siniawski, B. Edelmann, T. Tedoriya, and R. Hetzer
Transient sinus node dysfunction after the Cox-maze III procedure in patients with organic heart disease and chronic fixed atrial fibrillation
J. Am. Coll. Cardiol., October 1, 1998; 32(4): 1040 - 1047.
[Abstract] [Full Text] [PDF]

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 Asian Cardiovasc. Thorac. Ann.Home page
M. Hioki, Y. Iedokoro, S. Yamagishi, Y. Yamashita, K. Orii, S. Hirano, T. Hirata, N. Kutukata, S. Masuda, T. Hisayoshi, et al.
Mitral Valve Replacement and Preservation of Subvalvular Apparatus Using Cox's Maze Operation
Asian Cardiovasc Thorac Ann, September 1, 1998; 6(3): 216 - 218.
[Abstract] [Full Text] [PDF]

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 J. Thorac. Cardiovasc. Surg.Home page
F. Isobe and Y. Kawashima
The outcome and indications of the Cox maze III procedure for chronic atrial fibrillation with mitral valve disease
J. Thorac. Cardiovasc. Surg., August 1, 1998; 116(2): 220 - 224.
[Abstract] [Full Text] [PDF]


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