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J Thorac Cardiovasc Surg 1995;110:473-484
© 1995 Mosby, Inc.
SURGERY FOR ACQUIRED HEART DISEASE |
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 Dec. 14, 1994. 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 original maze procedure that was described for the treatment of patients with atrial fibrillation was followed by an unacceptable incidence of two problems: (1) the frequent inability to generate an appropriate sinus tachycardia in response to maximal exercise and (2) occasional left atrial dysfunction. In an effort to overcome these problems, we modified the original technique (maze I) twice. The results of these modifications culminated in the maze III procedure, which is associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. In addition, the maze III procedure is technically less demanding than either the maze I or maze II procedure. Therefore, the maze III procedure is now the technique of choice for the management of medically refractory atrial fibrillation. (J THORAC CARDIOVASC SURG 1995;110:473-84)
During the past several years, the maze procedure has become an important method of treating patients with medically refractory atrial flutter and atrial fibrillation
1-11 Follow-up evaluation of the first 32 patients to undergo the maze procedure revealed that two late postoperative problems occurred in some patients: (1) inability to generate an appropriate sinus tachycardia in response to maximal exercise and (2) occasional postoperative left atrial dysfunction. Because of these late postoperative problems, the surgical technique was modified.
Between September 25, 1987, and June 25, 1994, 123 patients underwent the maze procedure for the treatment of atrial flutter or atrial fibrillation, or both. Thirty-two of the first 33 patients underwent the standard maze I procedure (Fig. 1) described previously. 4 The surgical technique was modified (maze II procedure) in patients 34 through 48 (Fig. 2) and again (maze III procedure) in patients 49 through 123 (Fig. 3). 12 Patient 2 underwent the equivalent of the maze III procedure and is included in that group. The demographics of these three groups of patients are listed in Table I.
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Inability to generate an appropriate sinus tachycardia after the operation
Detailed electrophysiologic mapping studies in our laboratory have documented the presence of an atrial pacemaker complex both in dogs and in human beings. 13,14 The atrial pacemaker complex, an area of 2 by 5 cm, is centered about the anatomic sinoatrial (SA) node. Points of earliest activation can occur anywhere within this area, and the site of impulse origin changes, together with changes in rate, in response to differing humoral and neural inputs. For example, during humorally mediated sinus bradycardia (e.g., propranolol-induced), the sinus impulse usually originates from the lower portion of the atrial pacemaker complex near the orifice of the inferior vena cava (IVC) below the anatomic SA node. On the contrary, sinus tachycardia, whether humorally or neurally mediated, can originate from the region of the right atrium immediately anterior to the junction of the superior vena cava (SVC) with the right atrium (Fig. 4).
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4 the maze procedure (maze I) included several incisions around the SA node, one of which was located directly anterior to the junction of the SVC with the right atrium, that is, through the sinus tachycardia region of the right atrium (Fig. 1). The suspicion that this incision might prevent an appropriate sinus tachycardia after the operation was not raised until well into the clinical series of maze procedures because (1) the inability to generate an appropriate sinus tachycardia after the operation was not recognized initially and (2) the sinus tachycardia region of the right atrium was not identified in human beings until after the maze procedure had been introduced clinically. Once it became apparent that this incision was the most likely reason that an appropriate sinus tachycardia did not develop during maximal exercise in some patients, the incision was eliminated.
The maze I procedure and its first modification (maze II procedure) were evaluated extensively in the research laboratory for several years, the maze II procedure being evaluated exclusively for more than 2 years. 3,15-19 Once the incisions around the SA node were deleted, it became necessary to add a counterincision on the anterior right atrium to prevent reentry from developing around the base of the right atrium (Fig. 2). The incision that had previously extended from the base of the excised right atrial appendage, across the atrial septum, and then across the dome of the left atrium to the base of the left atrial appendage (Fig. 1) also had to be modified extensively. So that the sinus impulse could travel anteriorly across the left atrium and still not reenter around the SVC orifice, it was necessary to move the left atrial dome incision slightly more posteriorly and to terminate its right end in the medial SVC orifice (Fig. 2).
The combination of moving the left atrial dome incision more posteriorly and adding the anterior right atrial counterincision solved the problem of the incisions around the SA node, particularly through the sinus tachycardia region, and it also prevented reentry around either the base of the right atrium or the orifice of the SVC. Thus this maze II procedure was equal to the maze I procedure in preventing atrial fibrillation, and it had the theoretical advantage of having less adverse long-term effects on the SA node and interatrial conduction. Unfortunately, significant new technical problems were introduced with the maze II procedure. Because the position of the left atrial dome incision determines the position of the atrial septal incision, moving the former more posteriorly also moved the latter more posteriorly. Thus the atrial septotomy in the maze II procedure was located directly below the orifice of the SVC (Fig. 2, right panel) rather than anterior to the SVC orifice (Fig. 1, right panel). This made exposure for the left atrial incisions extremely difficult. In fact, after these modifications, the only way to gain adequate left-sided exposure was to divide the SVC and retract the entire right atrium anteriorly.
It is important to recognize that in both the maze I and the maze II procedures, there are two incisions that terminate in the orifice of the SVC (Figs 1 and 2). It is virtually impossible to close these two incisions without narrowing the distal portion of the SVC. Therefore, it was necessary to patch one of these incisions, our own preference being to use autologous pericardium. Thus, at the completion of the maze II procedure, it was necessary to close the two longitudinal incisions in the distal SVC, patch one of them, and then reapproximate the divided ends of the SVC, all of which occurred in the distal 2 to 3 cm of the SVC. Because of the fragile nature of the SVC and the extensive surgery required in a small area of the terminal SVC, this was the most technically demanding and time-consuming portion of the maze II procedure. In addition, the maze II procedure did not appear to correct all problems associated with the maze I procedure. As a result, further modifications of the technique were required.
Postoperative left atrial dysfunction
The original animal studies evaluating the effects of the maze I procedure on atrial blood flow confirmed that the multiple atriotomies did not cause any early or late atrial myocardial ischemia. 18-20 Therefore, the apparent lack of left atrial function in some patients after the operation prompted a search for other causes. Because the right atrium was documented to function normally in all patients both early and late after the operation, it seemed that the most likely explanation for the occasional absence of left atrial function was interatrial conduction delay. The relationship between delayed interatrial conduction and the absence of detectable left atrial function can be explained as follows.
Normally, the sinus impulse originates near the top of the right atrium and propagates rapidly (within approximately 40 msec) to the top of the left atrium across Bachmann's bundle, a thick band of atrial muscle fibers extending from the region of the SA node to the top of the left atrium. 21,22 This early arrival of the sinus impulse in the left atrium allows both atria to activate almost simultaneously from top to bottom, which thereby forces blood into their respective ventricles in the most efficient manner. Bachmann's bundle is either divided (Fig. 1) or incorporated (Fig. 2) in the left atrial dome incision in the maze I and maze II procedures, respectively. Therefore, it is not always possible for the sinus impulse to arrive as early as normal in the left atrium. Indeed, after the maze I and maze II procedures, it may occasionally take as long as 150 msec for the sinus impulse to propagate from the right atrium to the left atrium in some patients. If the atrioventricular (AV) interval in such a patient is also 150 msec, the sinus impulse will arrive in the left atrium and the left ventricle at virtually the same time. As a result, the left atrium and left ventricle will contract simultaneously and therefore effective left atrial contraction will not occur. However, because right atrial activation will still precede right ventricular contraction by 150 msec, right atrial function will appear to be normal. In such a patient, the follow-up studies of atrial transport function will document normal right atrial function with no left atrial function.
In an effort to overcome this problem of prolonged interatrial conduction time, we modified the maze II procedure by moving the entire left atrial dome incision more posteriorly (maze III, Fig. 3). This, in turn, caused the atrial septotomy to be moved more posteriorly as well. This rather minor modification resulted in several dramatic technical and functional improvements in the maze procedure concept. First, with the atrial septotomy now being posterior to the SVC, the exposure of the left side of the heart is superb. Furthermore, in the maze III procedure, only one incision extends into the SVC orifice (Fig. 3); therefore, pericardial patching is no longer necessary. The maze III procedure thus addresses both the chronotropic incompetence of the sinus node and the occasional dysfunction of the left atrium while making the procedure much easier to perform technically.
RESULTS
Early results (<3 months after the operation)
Three of 123 patients (2.4%) died in the perioperative period, the first after the maze II procedure combined with a Morrow myotomy and myectomy for end-stage hypertrophic obstructive cardiomyopathy. Two deaths followed the maze III procedure. The first occurred in a 72-year-old coal miner with black lung disease who died of postoperative respiratory insufficiency, and the second occurred in a 72-year-old man who had an unexpected cardiac arrest as a result of delayed cardiac tamponade. There have been no other early or late deaths.
The most common complications after all three procedures were perioperative atrial arrhythmias and early postoperative fluid retention (Table II). Only one perioperative stroke occurred (maze I), and it completely resolved within several weeks. There were two additional transient ischemic attacks (TIAs) and one perioperative myocardial infarction. Except for postoperative fluid retention, which was recognized after patient 7 and greatly attenuated thereafter by the administration of spironolactone, there were no significant differences in perioperative morbidity among the three procedures.
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There has been only one late TIA and there have been no late strokes related to the surgical procedures, to the occasional short-term postoperative anticoagulation, or to recurrent atrial arrhythmia. One patient who did not receive anticoagulation had a hemorrhagic stroke 38 months after the operation as a result of long-standing, severe hypertension that was present before the operation.
The TIA occurred in a 48-year-old man who had paroxysmal atrial flutter for 6 years before the operation. He had two thromboembolic episodes before the operation, one TIA and one embolism to the superior mesenteric artery. Postoperatively, he had a brief episode of atrial flutter at 5 months and another at 19 months. However, the TIA occurred during normal sinus rhythm 12 months after the operation. The TIA involved the face only and resolved completely within 1 hour. The patient is now receiving warfarin and has remained in normal sinus rhythm for the past 18 months.
Postoperative SA node function
The different types of maze procedures had substantially different effects on late function of the SA node (Table III). Using the criteria of a normal SA node before the operation followed by the necessity for a permanent pacemaker after the operation, the surgical procedure itself resulted in injury of the SA node in only two patients, one after the maze I procedure (3%) and one after the maze III procedure (2%). However, the prevalence of inappropriate resting sinus tachycardia increased with the maze III procedure. This phenomenon occurred between 4 and 12 months after the operation and was characterized by an average resting heart rate of 120 beats/min. All 15 patients with this problem were successfully treated with low-dose oral ß-adrenergic blockers.
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Table III and Fig. 5). The average maximal postoperative heart rate with exercise was 116 ± 15 beats/min after the maze I procedure, 132 ± 14 beats/min after the maze II procedure, and 139 ± 19 beats/min after the maze III procedure (p < 0.05 comparing maze II to maze I; p < 0.001 comparing maze III to maze I). This maximum chronotropic response of the SA node to exercise, regardless of the type of maze procedure performed, varies with time (Fig. 6). For example, if the maximum rate response to exercise is plotted against time after operation for each of the three types of maze procedures, regression analysis reveals significance for both the type of operation and the time since operation.
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10 Nevertheless, the requirements for permanent pacemakers decreased substantially after the incisions around the SA node were deleted, that is, after the maze II and maze III procedures (Table IV).
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Table V). All five patients were treated successfully with a single antiarrhythmic drug. Seven patients had recurrent atrial fibrillation, three of 32 patients after the maze I procedure (9%) and four of 65 (6%) after the maze III procedure. In six of the seven patients the arrhythmia converted to sinus rhythm with medical therapy, and only one patient remains in atrial fibrillation. That patient had a maze I procedure. Thus all patients who had either a maze II or a maze III procedure are now free of atrial flutter and atrial fibrillation (Table VI).
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Table VII). However, the technical modifications described resulted in an increase in the prevalence of postoperative sinus rhythm from 44% after the maze I procedure to 75% after the maze III procedure.
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By June 25, 1994, 90 patients had been reevaluated approximately 6 months after the operation specifically for the presence or absence of right atrial, left atrial, and overall atrial transport function. These evaluations included all of the same tests performed during the operation, except direct visualization, and the same criteria for positive results were used. Right atrial transport function was documented to be present in 98% of all patients regardless of the type of maze procedure that had been performed (Table VIII). On the contrary, left atrial transport function was present in 72% of patients after the maze I procedure and in 64% of patients after the maze II procedure (Table IX). However, further modification of the technique, as described earlier, resulted in left atrial transport function in 94% of patients after the maze III procedure. Moreover, when compared with ventricular pacing, AV sequential pacing at the same rate resulted in an increase in the thermodilution cardiac output in 52 of 54 patients so evaluated, which confirmed atrial contribution to forward cardiac output in 94% of all patients, regardless of the type of maze procedure performed.
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Because of the documented efficacy of the maze I procedure in ablating atrial flutter and atrial fibrillation, we were reluctant to alter the placement of the atriotomies. However, when it became apparent that several patients had a poor chronotropic response to exercise and others had left atrial dysfunction, experimental studies were initiated to evaluate the possibility of rearranging the atrial incisions to overcome these two problems. One of the risks involved in modifying the maze I procedure was that the modified procedure might prove to be less efficacious in ablating the arrhythmias. In addition, the possibility also existed of replacing one set of postoperative problems with another.
The first modification, the maze II procedure, was extremely difficult to perform technically. Nevertheless, it was eventually introduced clinically and proved to be as safe and effective as the maze I procedure. A further slight modification, however, completely changed the degree of technical difficulty and has since become the technique of choice, the maze III procedure. The present analysis of our clinical results indicate that the maze III procedure is likewise as safe and effective as its predecessors. The slightly higher operative mortality rate associated with the maze III procedure in this series reflects the expansion of surgical application to a higher risk group of patients. The perioperative morbidity is essentially the same for all three procedures.
Inappropriate sinus tachycardia is slightly more prevalent several months after the maze III procedure, but this is a minor clinical problem that is easily controlled. More important, after the maze III procedure, the pacemaker requirements are less than one half those after the original procedure and the chronotropic response to maximal exercise is entirely normal in more than 87% of patients. Moreover, inasmuch as the chronotropic response to exercise is time-dependent, this number can be expected to increase on further follow-up. Thus it would appear that deletion of the maze I incision that traversed the sinus tachycardia region of the atrial pacemaker complex alleviated the problem of a blunted sinus node response to postoperative exercise.
Translocating the left atrial dome incision to a more posterior position behind Bachmann's bundle resulted in a higher incidence of detectable left atrial function after the maze III procedure than after either of its predecessors. Indeed, after the maze III procedure, right atrial function is preserved or restored in 98% of patients and left atrial function is preserved or restored in 94% of patients. However, even in the patients who have no detectable left atrial function, regardless of the type of procedure, the atria as a whole contribute to the improvement of forward cardiac output. This clinical finding is entirely consistent with the experimental observations made 15 years ago when we 23 analyzed the effects of surgical isolation of the left atrium from the rest of the heart. Those studies showed that as long as there is right atrial-to-right ventricular synchrony and preserved right atrial function, the forward cardiac output is normal regardless of whether the left atrium is contracting. In such a situation, the normal right-sided AV synchrony results in a normal right-sided cardiac output, which is delivered, via the pulmonary vascular bed, to the left side of the heart. The left ventricle adapts instantaneously to this normal right-sided output, by increasing its end-diastolic volume, and delivers a normal left-sided output. Neither the synchronicity nor the strength of contraction of the left atrium has any effect on these hemodynamic interactions between the right and left sides of the heart provided the left ventricle is not dysfunctional.
Simply documenting the presence or absence of atrial contraction by one or more of these techniques does not address two important questions regarding how to interpret the functional results of these surgical procedures for the management of atrial fibrillation. The first question is this: "What is the amount of atrial transport function that is preserved or restored after operations for paroxysmal or chronic atrial fibrillation?" Overall atrial transport function is easily quantitated by differential atrial versus AV sequential pacing. Although efforts have been made to quantitate individual right atrial or left atrial transport function using Doppler flow studies across the respective AV valves, 19 no satisfactory method has been developed for quantitating the transport function of one atrium independently from the other atrium. Therefore, although our postoperative Doppler flow studies demonstrate that both right atrial and left atrial transport function are indeed present after the various maze procedures, the magnitude of that atrial contraction in comparison with that of a normal atrium is impossible to quantitate. It is safe to assume, however, that any atrial contraction is better than no atrial contraction, the condition that occurs during atrial fibrillation. Furthermore, our differential pacing studies demonstrate that the synchronous contraction of both atria with the ventricles (AV sequential pacing) results in a substantial increase in forward cardiac output in comparison with that measured in the absence of atrial contraction (ventricular pacing alone).
The second question is this: "How much left atrial function is necessary to alleviate the risk of systemic thromboembolism?" Although the answer is unknown, some interesting and pertinent observations can be made. It is generally accepted that the major reason that atrial fibrillation leads to mural thrombi in the left atrium is stasis of blood in that chamber. It is important to remember, however, that both atria fibrillate during atrial fibrillation. Therefore, one might expect blood stasis to be just as prominent in the right atrium as it is in the left atrium, yet mural thrombosis in the right atrium with pulmonary embolism is not commonly associated with atrial fibrillation. What is different about the left atrium? The most obvious relevant difference is the compartment-like anatomy of the left atrial appendage with a narrow, definitive introitus and long hollow body that is located peripheral to the main flow stream of blood in the left atrium compared with the broad-based, poorly defined entrance into the shallow right atrial appendage that is immediately adjacent to the main flow stream of blood in the right atrium. Thus excision of the left atrial appendage would intuitively seem to decrease the subsequent threat of left atrial thrombus formation. If, in addition, synchronous contraction of the left atrium with the left ventricle is restored, regardless of how strong or how feeble that contraction, the threat of thromboembolism should be decreased even further. Indeed, the pulmonary veins do not contract, yet they are not a source of mural thrombi. Therefore, if the main source of thrombi, the atrial appendage, is removed from the left atrium, and regular, rhythmic blood flow is reestablished through the left atrium by the restoration of a sinus rhythm, it is conceivable that the threat of thromboembolism would be alleviated regardless of whether the left atrium is contracting at all. On the other hand, if the left atrium is contracting, as it has been shown to be in 94% of our patients, the threat of thromboembolism should be eliminated. This reasoning is consistent with our results in the 28 patients with documented evidence of systemic thromboembolism related to preoperative atrial fibrillation, one of whom had had four separate strokes and a severe myocardial infarction because of embolization of the right coronary artery before the operation. Postoperatively, only one TIA has occurred in any of these patients in nearly 7 years after the maze procedure.
In summary, the original maze I procedure was sometimes followed by an inadequate chronotropic response of the SA node to maximum exercise and by occasional left atrial dysfunction. The technical modifications, culminating in the maze III procedure, have been successful in alleviating those two late postoperative problems without changing the efficacy of the procedure in curing atrial flutter and atrial fibrillation. Indeed, in comparison with the maze I procedure, the maze III procedure is associated with a higher incidence of postoperative sinus rhythm, improved long-term SA node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. In addition, the maze III procedure is technically less demanding than either the maze I or maze II procedure. For these reasons, the maze III procedure is now the technique of choice for the surgical treatment of patients with atrial fibrillation.
References
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|
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|
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|
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|
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|
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Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]
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V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]
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V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): 700 - 752. [Full Text] [PDF]
|
|
|
|
 |
|
 Authors/Task Force Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Eur. Heart J., August 2, 2006; 27(16): 1979 - 2030. [Full Text] [PDF]
|
|
|
|
|
|
J. M. Stulak, J. A. Dearani, R. C. Daly, K. J. Zehr, T. M. Sundt III, and H. V. Schaff Left Ventricular Dysfunction in Atrial Fibrillation: Restoration of Sinus Rhythm by the Cox-Maze Procedure Significantly Improves Systolic Function and Functional Status Ann. Thorac. Surg., August 1, 2006; 82(2): 494 - 501. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Jahangiri, G. Weir, K. Mandal, I. Savelieva, and J. Camm Current strategies in the management of atrial fibrillation. Ann. Thorac. Surg., July 1, 2006; 82(1): 357 - 364. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. E.W. Hemels, Y. L. Gu, A. E. Tuinenburg, P. W. Boonstra, A. C.P. Wiesfeld, M. P. van den Berg, D. J. Van Veldhuisen, and I. C. Van Gelder Favorable long-term outcome of maze surgery in patients with lone atrial fibrillation. Ann. Thorac. Surg., May 1, 2006; 81(5): 1773 - 1779. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Matsuura, H. Ogino, H. Matsuda, K. Minatoya, H. Sasaki, A. Kada, T. Yagihara, and S. Kitamura Prediction and Incidence of Atrial Fibrillation After Aortic Arch Repair Ann. Thorac. Surg., February 1, 2006; 81(2): 514 - 518. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Knaut, S. M. Tugtekin, S. G. Spitzer, F. Jung, and K. Matschke Intraoperative endocardial microwave ablation for treatment of permanent atrial fibrillation during coronary artery bypass surgery: 1-year follow-up. Europace, January 1, 2006; 8(1): 16 - 20. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Benussi and O. Alfieri Concomitant ablation of atrial fibrillation during mitral surgery MMCTS, November 29, 2005; 2005(1129): 1081. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. M. Sundt and B. J. Gersh Making Sense of the Maze: Which Patients With Atrial Fibrillation Will Benefit? JAMA, November 9, 2005; 294(18): 2357 - 2359. [Full Text] [PDF]
|
|
|
|
 |
|
 M.-C. Chen, J.-P. Chang, C.-J. Chen, C.-H. Yang, W. C. Hung, M. Fu, and K.-H. Yeh Atrial Pacemaker Complex Preserved Radiofrequency Maze Procedure Reducing the Incidence of Sick Sinus Syndrome in Patients With Atrial Fibrillation Chest, October 1, 2005; 128(4): 2571 - 2575. [Abstract] [Full Text] [PDF]
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|
|
|
|
|
T. Deneke, K. Khargi, K.-M. Muller, B. Lemke, A. Mugge, A. Laczkovics, A. E. Becker, and P. H. Grewe Histopathology of intraoperatively induced linear radiofrequency ablation lesions in patients with chronic atrial fibrillation Eur. Heart J., September 1, 2005; 26(17): 1797 - 1803. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
 |
|
 M. O'Donnell, G. Agnelli, and J. I. Weitz Emerging therapies for stroke prevention in atrial fibrillation Eur. Heart J. Suppl., May 1, 2005; 7(suppl_C): C19 - C27. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Hocini, P. Sanders, P. Jais, L.-F. Hsu, R. Weerasoriya, C. Scavee, Y. Takahashi, M. Rotter, F. Raybaud, L. Macle, et al. Prevalence of pulmonary vein disconnection after anatomical ablation for atrial fibrillation: consequences of wide atrial encircling of the pulmonary veins Eur. Heart J., April 1, 2005; 26(7): 696 - 704. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 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]
|
|
|
|
|
|
S. K. Dora, P. K. Varma, C. Parija, K. Nair, R. Sreedhar, K. S. Neelakandhan, and J. Tharakan Polymorphic ventricular tachycardia after radiofrequency maze procedure: Report of two cases J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 446 - 447. [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
M. Knaut, S. M. Tugtekin, F. Jung, and K. Matschke Microwave ablation for the surgical treatment of permanent atrial fibrillation--a single centre experience Eur. J. Cardiothorac. Surg., October 1, 2004; 26(4): 742 - 746. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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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|
|
 |
|
 B. Chiappini, R. Di Bartolomeo, and G. Marinelli Radiofrequency Ablation for Atrial Fibrillation: Different Approaches Asian Cardiovasc Thorac Ann, September 1, 2004; 12(3): 272 - 277. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-C. Chen, J.-P. Chang, and H.-W. Chang Preoperative Atrial Size Predicts the Success of Radiofrequency Maze Procedure for Permanent Atrial Fibrillation in Patients Undergoing Concomitant Valvular Surgery Chest, June 1, 2004; 125(6): 2129 - 2134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Quader, P. M. McCarthy, A. M. Gillinov, J. M. Alster, D. M. Cosgrove III, B. W. Lytle, and E. H. Blackstone Does preoperative atrial fibrillation reduce survival after coronary artery bypass grafting? Ann. Thorac. Surg., May 1, 2004; 77(5): 1514 - 1524. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. A. Romano, D. S. Bach, F. D. Pagani, R. L. Prager, G. M. Deeb, and S. F. Bolling Atrial reduction plasty Cox maze procedure: extended indications for atrial fibrillation surgery Ann. Thorac. Surg., April 1, 2004; 77(4): 1282 - 1287. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. R. Mott, T. F. Feltes, E. D. McKenzie, D. B. Andropoulos, L. I. Bezold, A. L. Fenrich, S. L. Bedford, H. El-Said, S. A. Stayer, and C. D. Fraser Jr Improved early results with the Fontan operation in adults with functional single ventricle Ann. Thorac. Surg., April 1, 2004; 77(4): 1334 - 1340. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. M. Prasad, H. S. Maniar, C. J. Camillo, R. B. Schuessler, J. P. Boineau, T. M. Sundt III, J. L. Cox, and R. J. Damiano Jr The Cox maze III procedure for atrial fibrillation: long-term efficacy in patients undergoing lone versus concomitant procedures J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 1822 - 1827. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. J. Damiano Jr, S. L. Gaynor, M. Bailey, S. Prasad, J. L. Cox, J. P. Boineau, and R. P. Schuessler The long-term outcome of patients with coronary disease and atrial fibrillation undergoing the cox maze procedure J. Thorac. Cardiovasc. Surg., December 1, 2003; 126(6): 2016 - 2021. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stollberger, B. Schneider, and J. Finsterer Elimination of the Left Atrial Appendage To Prevent Stroke or Embolism?: Anatomic, Physiologic, and Pathophysiologic Considerations Chest, December 1, 2003; 124(6): 2356 - 2362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Thomas, A. Boyd, S. P. Thomas, N. B. Schiller, and D. L. Ross Atrial structural remodelling and restoration of atrial contraction after linear ablation for atrial fibrillation Eur. Heart J., November 1, 2003; 24(21): 1942 - 1951. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Kondo, K. Takahashi, M. Minakawa, and K. Daitoku Left atrial maze procedure: a useful addition to other corrective operations Ann. Thorac. Surg., May 1, 2003; 75(5): 1490 - 1494. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Vignati, G. Crupi, V. Vanini, F. S. Iorio, A. Borghi, and S. Giusti Surgical treatment of arrhythmias related to congenital heart diseases Ann. Thorac. Surg., April 1, 2003; 75(4): 1194 - 1199. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Cox Intraoperative options for treating atrial fibrillation associated with mitral valve disease J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(90030): S24 - 27. [Full Text] [PDF]
|
|
|
|
|
|
S. P. Thomas, D. J.R. Guy, A. C. Boyd, V. E. Eipper, D. L. Ross, and R. B. Chard Comparison of epicardial and endocardial linear ablation using handheld probes Ann. Thorac. Surg., February 1, 2003; 75(2): 543 - 548. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. L. Cox Surgical Treatment of Supraventricular Tachyarrhythmias Card. Surg. Adult, January 1, 2003; 2(2003): 1271 - 1286. [Full Text]
|
|
|
|
|
|
S. P. Setty, K. Finucane, J. R. Skinner, and A. R. Kerr Extracardiac conduit with a limited maze procedure for the failing Fontan with atrial tachycardias Ann. Thorac. Surg., December 1, 2002; 74(6): 1992 - 1997. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Gillinov, E. H. Blackstone, and P. M. McCarthy Atrial fibrillation: current surgical options and their assessment Ann. Thorac. Surg., December 1, 2002; 74(6): 2210 - 2217. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Benussi, S. Nascimbene, E. Agricola, G. Calori, S. Calvi, A. Caldarola, M. Oppizzi, V. Casati, C. Pappone, and O. Alfieri Surgical ablation of atrial fibrillation using the epicardial radiofrequency approach: mid-term results and risk analysis Ann. Thorac. Surg., October 1, 2002; 74(4): 1050 - 1057. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Deneke, K. Khargi, P. H. Grewe, S. von Dryander, F. Kuschkowitz, T. Lawo, K.-M. Muller, A. Laczkovics, and B. Lemke Left atrial versus bi-atrial maze operation using intraoperatively cooled-tip radiofrequency ablation in patients undergoing open-heart surgery: Safety and efficacy J. Am. Coll. Cardiol., May 15, 2002; 39(10): 1644 - 1650. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P.-S. Chen, T.-J. Wu, C. Hwang, S. Zhou, Y. Okuyama, A. Hamabe, Y. Miyauchi, C.-M. Chang, L. S. Chen, M. C. Fishbein, et al. Thoracic veins and the mechanisms of non-paroxysmal atrial fibrillation Cardiovasc Res, May 1, 2002; 54(2): 295 - 301. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T Deneke, K Khargi, P.H Grewe, A Laczkovics, S von Dryander, T Lawo, K.-M Muller, and B Lemke Efficacy of an additional MAZE procedure using cooled-tip radiofrequency ablation in patients with chronic atrial fibrillation and mitral valve disease. A randomized, prospective trial Eur. Heart J., April 1, 2002; 23(7): 558 - 566. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Guang, C. Zhen-jie, L. Wei Yong, L. Tong, and L. Ying Evaluation of clinical treatment of atrial fibrillation associated with rheumatic mitral valve disease by radiofrequency ablation Eur. J. Cardiothorac. Surg., February 1, 2002; 21(2): 249 - 254. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. Yoshihara, T. Nishikimi, Y. Sasako, J. Hino, J. Kobayashi, K. Minatoya, K. Bando, Y. Kosakai, T. Horio, S.-i. Suga, et al. Plasma atrial natriuretic peptide concentration inversely correlates with left atrial collagen volume fraction in patients with atrial fibrillation: Plasma ANP as a possible biochemical marker to predict the outcome of the maze procedure J. Am. Coll. Cardiol., January 16, 2002; 39(2): 288 - 294. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Lonnerholm, P. Blomstrom, L. Nilsson, and C. Blomstrom-Lundqvist Atrial size and transport function after the Maze III procedure for paroxysmal atrial fibrillation Ann. Thorac. Surg., January 1, 2002; 73(1): 107 - 111. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Thomas, I. A. Nicholson, G. R. Nunn, and D. L. Ross Radiofrequency lesions produced by handheld temperature controlled probes for use in atrial fibrillation surgery Eur. J. Cardiothorac. Surg., December 1, 2001; 20(6): 1188 - 1193. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G.Y.H. Lip and F.L. L. S. Hee Paroxysmal atrial fibrillation QJM, December 1, 2001; 94(12): 665 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Pasic, P. Bergs, P. Muller, M. Hofmann, O. Grauhan, H. Kuppe, and R. Hetzer Intraoperative radiofrequency maze ablation for atrial fibrillation: the Berlin modification Ann. Thorac. Surg., November 1, 2001; 72(5): 1484 - 1491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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 Circulation, October 23, 2001; 104(17): 2118 - 2150. [Full Text] [PDF]
|
|
|
|
|
|
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. [PDF]
|
|
|
|
|
|
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. [Full Text] [PDF]
|
|
|
|
|
|
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. [Full Text] [PDF]
|
|
|
|
|
|
E. P. Bauer, Z. A. Szalay, R. R. Brandt, H. F. Pitschner, G. Bachmann, H.-P. Brunner-La Rocca, and W. P. Klovekorn Predictors for atrial transport function after mini-maze operation Ann. Thorac. Surg., October 1, 2001; 72(4): 1251 - 1255. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. P. Thomas, G. R. Nunn, I. A. Nicholson, A. Rees, M. P. J. Daly, R. B. Chard, and D. L. Ross Mechanism, localization and cure of atrial arrhythmias occurring after a new intraoperative endocardial radiofrequency ablation procedure for atrial fibrillation J. Am. Coll. Cardiol., February 1, 2000; 35(2): 442 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Harada, T. Konishi, M. Fukata, K. Higuchi, T. Sugimoto, and K. Sasaki Intraoperative map guided operation for atrial fibrillation due to mitral valve disease Ann. Thorac. Surg., February 1, 2000; 69(2): 446 - 450. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. B. Jatene, M. B. Marcial, F. Tarasoutchi, R. A. Cardoso, P. Pomerantzeff, and A. D. Jatene Influence of the maze procedure on the treatment of rheumatic atrial fibrillation - evaluation of rhythm control and clinical outcome in a comparative study Eur. J. Cardiothorac. Surg., February 1, 2000; 17(2): 117 - 124. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Izumoto, K. Kawazoe, K. Eishi, and J. Kamata Medium-term results after the modified Cox/Maze procedure combined with other cardiac surgery Eur. J. Cardiothorac. Surg., January 1, 2000; 17(1): 25 - 29. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. A. Szalay, W. Skwara, H.-F. Pitschner, I. Faude, W.-P. Klovekorn, and E. P. Bauer Midterm results after the mini-maze procedure Eur. J. Cardiothorac. Surg., September 1, 1999; 16(3): 306 - 311. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Berreklouw, F. Bracke, A. Meijer, K. H. Peels, and D. Relik Cardiogenic shock due to coronary narrowings one day after a MAZE III procedure Ann. Thorac. Surg., September 1, 1999; 68(3): 1065 - 1066. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. Shah, D. Shah, S. Calla, and V. Shah An Incision-Sparing Modification of the Maze Procedure Using Electrocoagulation Asian Cardiovasc Thorac Ann, June 1, 1999; 7(2): 164 - 164. [Full Text] [PDF]
|
|
|
|
|
|
R. Lee, T. Nitta, R. B. Schuessler, D. C. Johnson, J. P. Boineau, and J. L. Cox The closed heart MAZE: a nonbypass surgical technique Ann. Thorac. Surg., June 1, 1999; 67(6): 1696 - 1702. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Nitta, R. Lee, R. B. Schuessler, J. P. Boineau, and J. L. Cox Radial approach: a new concept in surgical treatment for atrial fibrillation I. Concept, anatomic and physiologic bases and development of a procedure Ann. Thorac. Surg., January 1, 1999; 67(1): 27 - 35. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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]
|
|
|
|
|
|
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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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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M.-C. Chen, G. B.-F. Guo, J.-P. Chang, K.-H. Yeh, and M. Fu Radiofrequency and Cryoablation of Atrial Fibrillation in Patients Undergoing Valvular Operations Ann. Thorac. Surg., June 1, 1998; 65(6): 1666 - 1672. [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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D. A. Theodoro, G. K. Danielson, C.-b. J. Porter, and C. A. Warnes Right-Sided Maze Procedure for Right Atrial Arrhythmias in Congenital Heart Disease Ann. Thorac. Surg., January 1, 1998; 65(1): 149 - 154. [Abstract] [Full Text] [PDF]
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M. C. Robotin, A. Serraf, L. Houyel, J. Petit, F. Lacour-Gayet, J. Bruniaux, and C. Planche Prevention of Unbalanced Lung Perfusion and Atrial Arrhythmias After the Lateral Tunnel Operation Ann. Thorac. Surg., November 1, 1997; 64(5): 1389 - 1395. [Abstract] [Full Text]
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