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J Thorac Cardiovasc Surg 2003;126:1822-1827
© 2003 The American Association for Thoracic Surgery
Cardiopulmonary support and physiology |
a Division of Cardiothoracic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, Mo, USA
Read at the Eighty-second Annual Meeting of The American Association for Thoracic Surgery, Washington, DC, May 5-8, 2002.
Received for publication October 11, 2002; revisions received January 17, 2003; accepted for publication April 14, 2003.
* Address for reprints: Ralph J. Damiano, Jr, MD, Chief of Cardiac Surgery, Washington University School of Medicine, Barnes-Jewish Hospital, One Barnes-Jewish Plaza, Queeny Tower Suite 3108, St Louis, MO 63110, USA
damiano{at}msnotes.wustl.edu
BACKGROUND: For the last decade, the Cox maze III procedure has been available for the treatment of atrial fibrillation. It is unknown whether the operation has similar efficacy in patients with lone atrial fibrillation compared with that in patients with atrial fibrillation associated with coronary, valve, or congenital heart disease. This study examined the long-term outcome of patients who underwent this procedure either as a lone operation or as a concomitant procedure.
METHODS: From 1988 to 2001, 198 patients underwent a Cox maze III procedure; 112 were lone operations, and 86 were concomitant procedures. Major complications included renal failure, reoperation for bleeding, mediastinitis, stroke, and balloon pump insertion. Follow-up was performed by means of mail and telephone questionnaires with both the patients and their cardiologists. All patients who had any history of arrhythmia or who were taking medication had their rhythm documented by means of electrocardiography.
RESULTS: The lone operation group was significantly younger (51.3 ± 10.5 vs 58.8 ± 9.9 years) and had a higher male/female ratio (4:1 vs 2:1). There was no difference in operative mortality between groups (1.8% vs 1.2%). At a follow-up of 5.4 ± 2.9 years, 96.6% (172/178) of all patients were free of atrial fibrillation. There was no difference between the lone operation and concomitant procedure groups (95.9% vs 97.5%).
CONCLUSION: The Cox maze III procedure has equivalent operative risk and long-term efficacy in patients undergoing both lone operations and concomitant procedures. The Cox maze III procedure remains the standard against which alternative procedures for atrial fibrillation must be judged.
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J. Ninet, X. Roques, R. Seitelberger, C. Deville, J. L. Pomar, J. Robin, O. Jegaden, F. Wellens, E. Wolner, C. Vedrinne, et al. Surgical ablation of atrial fibrillation with off-pump, epicardial, high-intensity focused ultrasound: Results of a multicenter trial J. Thorac. Cardiovasc. Surg., September 1, 2005; 130(3): 803 - 803. [Abstract] [Full Text] [PDF]
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G. D. Byrd, S. M. Prasad, C. M. Ripplinger, T. R. Cassilly, R. B. Schuessler, J. P. Boineau, and R. J. Damiano Jr Importance of Geometry and Refractory Period in Sustaining Atrial Fibrillation: Testing the Critical Mass Hypothesis Circulation, August 30, 2005; 112(9_suppl): I-7 - I-13. [Abstract] [Full Text] [PDF]
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S. Benussi, S. Nascimbene, G. Calori, P. Denti, Z. Ziskind, S. Kassem, G. La Canna, C. Pappone, and O. Alfieri Surgical ablation of atrial fibrillation with a novel bipolar radiofrequency device J. Thorac. Cardiovasc. Surg., August 1, 2005; 130(2): 491 - 497. [Abstract] [Full Text] [PDF]
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M. E. Halkos, J. M. Craver, V. H. Thourani, F. Kerendi, J. D. Puskas, W. A. Cooper, and R. A. Guyton Intraoperative Radiofrequency Ablation for the Treatment of Atrial Fibrillation During Concomitant Cardiac Surgery Ann. Thorac. Surg., July 1, 2005; 80(1): 210 - 216. [Abstract] [Full Text] [PDF]
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M. E. Goldman and L. B. Croft Atrial Fibrillation: The Ancient Conundrum Defies Simple Solution J. Am. Coll. Cardiol., June 7, 2005; 45(11): 1813 - 1814. [Full Text] [PDF]
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K. Bando, H. Kasegawa, Y. Okada, J. Kobayashi, A. Kada, T. Shimokawa, M. Nasu, S. Nakatani, K. Niwaya, O. Tagusari, et al. Impact of preoperative and postoperative atrial fibrillation on outcome after mitral valvuloplasty for nonischemic mitral regurgitation J. Thorac. Cardiovasc. Surg., May 1, 2005; 129(5): 1032 - 1040. [Abstract] [Full Text] [PDF]
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M.-J. Baek, S.-S. Oh, C.-H. Lee, and C.-Y. Na Outcome of the modified maze procedure for atrial fibrillation combined with rheumatic mitral valve disease using cryoablation Interactive CardioVascular and Thoracic Surgery, April 1, 2005; 4(2): 130 - 134. [Abstract] [Full Text] [PDF]
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C. C. Lang, V. Santinelli, G. Augello, A. Ferro, F. Gugliotta, S. Gulletta, G. Vicedomini, C. Mesas, G. Paglino, S. Sala, et al. Transcatheter radiofrequency ablation of atrial fibrillation in patients with mitral valve prostheses and enlarged atria: Safety, feasibility, and efficacy J. Am. Coll. Cardiol., March 15, 2005; 45(6): 868 - 872. [Abstract] [Full Text] [PDF]
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S. J. Hazel, H. S. Paterson, J. R.M. Edwards, and G. J. Maddern Surgical Treatment of Atrial Fibrillation via Energy Ablation Circulation, March 1, 2005; 111(8): e103 - e106. [Full Text] [PDF]
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T. Nitta, H. Ohmori, S.-i. Sakamoto, Y. Miyagi, S. Kanno, and K. Shimizu Map-guided surgery for atrial fibrillation J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 291 - 299. [Abstract] [Full Text] [PDF]
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S. L. Gaynor, R. B. Schuessler, M. S. Bailey, Y. Ishii, J. P. Boineau, M. J. Gleva, J. L. Cox, and R. J. Damiano Jr Surgical treatment of atrial fibrillation: Predictors of late recurrence J. Thorac. Cardiovasc. Surg., January 1, 2005; 129(1): 104 - 111. [Abstract] [Full Text] [PDF]
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J. L. Monro The next challenge--adapting to change Eur. J. Cardiothorac. Surg., December 1, 2004; 26(6): 1063 - 1072. [Full Text] [PDF]
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S. Benussi Treatment of atrial fibrillation Eur. J. Cardiothorac. Surg., December 1, 2004; 26(Suppl_1): S39 - S41. [Abstract] [Full Text] [PDF]
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N. A. Mokadam, P. M. McCarthy, A. M. Gillinov, W. H. Ryan, M. R. Moon, M. J. Mack, S. L. Gaynor, S. M. Prasad, S. A. Wickline, M. S. Bailey, et al. A Prospective Multicenter Trial of Bipolar Radiofrequency Ablation for Atrial Fibrillation: Early Results Ann. Thorac. Surg., November 1, 2004; 78(5): 1665 - 1670. [Abstract] [Full Text] [PDF]
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S. L. Gaynor, Y. Ishii, M. D. Diodato, S. M. Prasad, K. M. Barnett, N. R. Damiano, G. D. Byrd, S. A. Wickline, R. B. Schuessler, and R. J. Damiano Jr Successful Performance of Cox-Maze Procedure on Beating Heart Using Bipolar Radiofrequency Ablation: A Feasibility Study in Animals Ann. Thorac. Surg., November 1, 2004; 78(5): 1671 - 1677. [Abstract] [Full Text] [PDF]
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S. L. Gaynor, M. D. Diodato, S. M. Prasad, Y. Ishii, R. B. Schuessler, M. S. Bailey, N. R. Damiano, J. B. Bloch, M. R. Moon, and R. J. Damiano Jr A prospective, single-center clinical trial of a modified Cox maze procedure with bipolar radiofrequency ablation J. Thorac. Cardiovasc. Surg., October 1, 2004; 128(4): 535 - 542. [Abstract] [Full Text] [PDF]
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Y. Ishii, M. J. Gleva, M. C. Gamache, R. B. Schuessler, J. P. Boineau, M. S. Bailey, and R. J. Damiano Jr Atrial Tachyarrhythmias After the Maze Procedure: Incidence and Prognosis Circulation, September 14, 2004; 110(11_suppl_1): II-164 - II-168. [Abstract] [Full Text] [PDF]
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R. M. John and G. Michaud Atrial Fibrillation: Nonpharmacologic Therapies Coming of Age Chest, June 1, 2004; 125(6): 1977 - 1979. [Full Text] [PDF]
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R. B. Schuessler Do we need a map to get through the maze? J. Thorac. Cardiovasc. Surg., March 1, 2004; 127(3): 627 - 628. [Full Text] [PDF]
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