The Cox-Maze Procedure for Lone Atrial Fibrillation: A Single-Center Experience Over 2 Decades
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چکیده
This study reviews our experience in the surgical treatment of atrial fibrillation (AF) during the past 2 decades in 212 consecutive patients with lone AF. Freedom from AF in the original Cox-Maze III procedure was 93%. However, the procedure was difficult to perform and had a 10% rate of major complications. By using radiofrequency bipolar clamp technology to replace surgical incisions with transmural lesions, we modified the procedure (CoxMaze IV), essentially maintaining the original pattern of lesions. Our results demonstrate that the procedure is much easier to perform, the time to perform the procedure is reduced, and the major complication rate declined to 1%. The present study shows that freedom from AF is still 90% and even off antiarrhythmics it is 83%. Thus, we were able to maintain the efficacy of the original procedure and make it more accessible to a wider cohort of patients. The Cox-Maze IV represents a therapeutic option for lone AF in patients who have had clinical symptoms despite medical treatment or in whom a catheter ablation has failed, patients who have had a stroke despite anticoagulation therapy, and patients who are not candidates for other therapies. The procedure can be performed with minimal risk. The results of this study also serve as a benchmark for the future development of procedures to treat lone AF.
منابع مشابه
The Cox-Maze Procedure for Lone Atrial Fibrillation: A Single Center Experience over Two Decades Running title: Weimar et al.; Cox-Maze Procedure for Lone Atrial Fibrillation
متن کامل
The Cox - Maze Procedure for Lone Atrial Fibrillation : A Single Center Experience over Two Decades
متن کامل
The cox-maze procedure for lone atrial fibrillation: a single-center experience over 2 decades.
BACKGROUND The Cox-Maze procedure (CMP) has achieved high success rates in the therapy of atrial fibrillation (AF) while becoming progressively less invasive. This report evaluates our experience with the CMP in the treatment of lone AF over 2 decades and compares the original cut-and-sew CMP-III to the ablation-assisted CMP-IV, which uses bipolar radiofrequency and cryoenergy to create the ori...
متن کاملA review of current surgical treatment of patients with atrial fibrillation.
Surgical therapy for patients with atrial fibrillation has undergone significant advances over the past 30 years. The Cox Maze III technique is currently the gold standard of care for these patients. However, Maze IV, a less complex procedure using alternative energy sources, is rapidly replacing the Cox Maze III in clinical practice. The use of alternative energy sources such as cryothermy and...
متن کاملExperience with various surgical options for the treatment of atrial fibrillation.
BACKGROUND New alternatives exist using various energy sources and lesion lines for the surgical treatment of atrial fibrillation (AF). The efficacy of these options compared to the cut-and-sew maze III procedure is unknown. METHODS From August 1996 to August 2003, 79 patients have undergone a procedure for AF, with 70 patients currently more than 3 months postsurgery. The patients (58 contin...
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تاریخ انتشار 2013