JTCS Speed Up Your Browser
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to Personal Folders
Right arrow Download to citation manager
Right arrow Author home page(s):
Eugene H. Blackstone
Patrick M. McCarthy
Gosta Pettersson
Lars G. Svensson
Jose L. Navia
Delos M. Cosgrove
Right arrow Permission Requests
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Gillinov, A. M.
Right arrow Articles by Natale, A.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Gillinov, A. M.
Right arrow Articles by Natale, A.
Related Collections
Right arrow Electrophysiology - arrhythmias
Right arrow Valve disease

J Thorac Cardiovasc Surg 2005;130:1653-1660
© 2005 The American Association for Thoracic Surgery

Surgery for Acquired Cardiovascular Disease

The Cox maze procedure in mitral valve disease: Predictors of recurrent atrial fibrillation

A. Marc Gillinov, MD a , * , Jon Sirak, MD a , Eugene H. Blackstone, MD a , b , Patrick M. McCarthy, MD a , Jeevanantham Rajeswaran, MSc b , Gosta Pettersson, MD, PhD a , F. Joseph Sabik, III, MD a , Lars G. Svensson, MD, PhD a , Jose L. Navia, MD a , Delos M. Cosgrove, MD a , Nassir Marrouche, MD c , Andrea Natale, MD c

a Center for Atrial Fibrillation and the Departments of Thoracic and Cardiovascular Surgery,
b Quantitative Health Sciences,
c Cardiovascular Medicine, The Cleveland Clinic Foundation, Cleveland, Ohio

Read at the Eighty-fifth Annual Meeting of The American Association for Thoracic Surgery, San Francisco, Calif, April 10-13, 2005.

Received for publication April 1, 2005; revisions received July 7, 2005; accepted for publication July 26, 2005.

* Address for reprints: A. Marc Gillinov, MD, Department of Thoracic and Cardiovascular Surgery, The Cleveland Clinic Foundation/F24, 9500 Euclid Ave, Cleveland, OH 44195 (Email: gillinom{at}ccf.org).

OBJECTIVES: The Cox maze procedure is the gold standard for ablation of atrial fibrillation in patients undergoing mitral valve surgery, and new approaches to atrial fibrillation ablation must be compared with it. Therefore, we sought to determine the time-related prevalence of atrial fibrillation and its risk factors after combined Cox maze and mitral valve surgery.

METHODS: From November 1991 through January 2004, 263 patients (mean left atrial diameter, 5.8 ± 1.2 cm) underwent combined mitral valve surgery (repair in 71%) and a cut-and-sew Cox maze procedure for atrial fibrillation (permanent, 74%; persistent, 7%; paroxysmal, 16%). Rhythm documented on 2367 postoperative electrocardiograms was used to estimate the prevalence of atrial fibrillation across time.

RESULTS: Hospital mortality was 1.9%. Postoperative atrial fibrillation prevalence peaked at 36% at 2 weeks, decreasing to 21% at 5 years. Risk factors for higher postoperative atrial fibrillation prevalence varied with time and included longer duration of preoperative atrial fibrillation (P = .003), larger left atrial diameter (P = .01), older age (P = .0002), and higher left ventricular mass index (P = .02).

CONCLUSIONS: In some patients undergoing mitral valve surgery and a Cox maze procedure, atrial fibrillation recurs over time, mandating close, long-term follow-up of heart rhythm. Earlier operation and left atrial size reduction should be considered to improve results in selected patients.

Abbreviations and Acronyms AF = atrial fibrillation; CL = confidence limit; ECG = electrocardiogram




This article has been cited by other articles:


Home page
 Eur. J. Cardiothorac. Surg.Home page
H. Grubitzsch, C. Grabow, H. Orawa, and W. Konertz
Factors predicting the time until atrial fibrillation recurrence after concomitant left atrial ablation.
Eur. J. Cardiothorac. Surg., July 1, 2008; 34(1): 67 - 72.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Marui, Y. Saji, T. Nishina, E. Tadamura, S. Kanao, T. Shimamoto, N. Sasahashi, T. Ikeda, and M. Komeda
Impact of left atrial volume reduction concomitant with atrial fibrillation surgery on left atrial geometry and mechanical function.
J. Thorac. Cardiovasc. Surg., June 1, 2008; 135(6): 1297 - 1305.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
H. Grubitzsch, A. Menes, D. Modersohn, and W. Konertz
The Role of Atrial Remodeling for Ablation of Atrial Fibrillation
Ann. Thorac. Surg., February 1, 2008; 85(2): 474 - 480.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. M. Gillinov
Choice of Surgical Lesion Set: Answers From the Data
Ann. Thorac. Surg., November 1, 2007; 84(5): 1786 - 1792.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
A. Marui, K. Tambara, E. Tadamura, Y. Saji, N. Sasahashi, T. Ikeda, T. Nishina, and M. Komeda
A novel approach to restore atrial function after the maze procedure in patients with an enlarged left atrium
Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 308 - 312.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K.-B. Kim
Reply to Villa et al.
Eur. J. Cardiothorac. Surg., August 1, 2007; 32(2): 399 - 399.
[Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
J. M. Stulak, T. M. Sundt III, J. A. Dearani, R. C. Daly, T. A. Orsulak, and H. V. Schaff
Ten-year Experience With the Cox-Maze Procedure for Atrial Fibrillation: How Do We Define Success?
Ann. Thorac. Surg., April 1, 2007; 83(4): 1319 - 1324.
[Abstract] [Full Text] [PDF]

Home page
 Eur. J. Cardiothorac. Surg.Home page
K. C. Kim, K. R. Cho, Y.-J. Kim, D.-W. Sohn, and K.-B. Kim
Long-term results of the Cox-Maze III procedure for persistent atrial fibrillation associated with rheumatic mitral valve disease: 10-year experience
Eur. J. Cardiothorac. Surg., February 1, 2007; 31(2): 261 - 266.
[Abstract] [Full Text] [PDF]

Home page
 StrokeHome page
A. M. Gillinov
Advances in Surgical Treatment of Atrial Fibrillation
Stroke, February 1, 2007; 38(2): 618 - 623.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
P. K.E.W. Ballaux, G. S.C. Geuzebroek, N. M. van Hemel, J. C. Kelder, K. M.E. Dossche, J. M.P.G. Ernst, L. V.A. Boersma, E. F.D. Wever, A. B. de la Riviere, and J. J.A.M.T. Defauw
Freedom from atrial arrhythmias after classic maze III surgery: A 10-year experience
J. Thorac. Cardiovasc. Surg., December 1, 2006; 132(6): 1433 - 1440.
[Abstract] [Full Text] [PDF]

Home page
 ICVTSHome page
R. R. Lecoq, J. M. Gracia, C. Sureda, and A. Igual
Subxyphoid approach for closed-chest atrial fibrillation surgery: the one hand operation
Interactive CardioVascular and Thoracic Surgery, December 1, 2006; 5(6): 669 - 671.
[Abstract] [Full Text] [PDF]

Home page
 J. Thorac. Cardiovasc. Surg.Home page
A. Marui, T. Nishina, K. Tambara, Y. Saji, T. Shimamoto, M. Nishioka, T. Ikeda, and M. Komeda
A novel atrial volume reduction technique to enhance the Cox maze procedure: initial results.
J. Thorac. Cardiovasc. Surg., November 1, 2006; 132(5): 1047 - 1053.
[Abstract] [Full Text] [PDF]

Home page
 Ann. Thorac. Surg.Home page
A. M. Gillinov, S. Bhavani, E. H. Blackstone, J. Rajeswaran, L. G. Svensson, J. L. Navia, B.G. Pettersson, J. F. Sabik III, N. G. Smedira, T. Mihaljevic, et al.
Surgery for Permanent Atrial Fibrillation: Impact of Patient Factors and Lesion Set
Ann. Thorac. Surg., August 1, 2006; 82(2): 502 - 514.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
ANN THORAC SURG ASIAN CARDIOVASC THORAC ANN EUR J CARDIOTHORAC SURG
J THORAC CARDIOVASC SURG ICVTS ALL CTSNet JOURNALS
Copyright © 2005 by The American Association for Thoracic Surgery.