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Cox Maze

Joshua Xu, Jessica G Y Luc, Kevin Phan
Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF...
September 2016: Journal of Thoracic Disease
Alessandro Giamberti, Francesca R Pluchinotta, Massimo Chessa, Alessandro Varrica, Raffaele Vitale, Alessandro Frigiola, Carlo Pappone, Marco Ranucci
AIMS: Supraventricular arrhythmias are a major cause of morbidity and mortality in adult patients with congenital heart disease (CHD). Intraoperative ablation offers an alternative for patients who failed ablation procedures or are requiring concomitant surgical intervention. We present our long-term results with the surgical treatment of arrhythmias in adults with CHD (ACHD) undergoing elective cardiac surgery and the clinical predictors for arrhythmia recurrence. METHODS AND RESULTS: Between 2002 and 2013, 80 consecutive patients with CHD, mean age of 39 years, underwent intraoperative ablation with monopolar irrigated radiofrequency during cardiac surgery procedures...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
N Rajasekar, Chandishwar Nath, Kashif Hanif, Rakesh Shukla
Alzheimer's disease (AD) is associated with reduced insulin level and impairment of insulin receptor (IR) signaling in the brain, which correlates to amyloid pathology, neuroinflammation, and synaptic neurotoxicity. Clinical studies show that intranasal insulin improves memory in AD patients without peripheral hypoglycemia. However, neuroprotective molecular mechanism of the beneficial effect of intranasal insulin in AD pathology is unexplored. Therefore, we investigated the role of intranasal insulin on intracerebroventricular (ICV) streptozotocin (STZ)-induced memory impairment in rats as evaluated in the Morris water maze test...
October 11, 2016: Molecular Neurobiology
Charlotte van Laar, Johannes Kelder, Bart P van Putte
The purpose of this study was to update the current evidence regarding the efficacy and safety of the totally thoracoscopic maze (TT-maze) procedure for the treatment of atrial fibrillation (AF). Fourteen studies published between 2011 and 2016 and comprising 1171 patients were included as follows: 545 (46%) patients had paroxysmal AF (pAF), 268 (23%) persistent AF (persAF) and 358 (31%) longstanding persistent AF (LSPAF). Fixed- and random-effect models were used to calculate the pooled overall freedom from atrial arrhythmias...
September 23, 2016: Interactive Cardiovascular and Thoracic Surgery
Harsh Agrawal, Kul Aggarwal, Martin A Alpert
Atrial standstill is a rare disorder of cardiac rhythm that is characterized by total absence of electrical activity in one or both atria. We report herein the case of a patient with atrial fibrillation and symptomatic 4.0 s pauses who received a ventricular demand pacemaker. The patient later underwent mitral valve replacement with a pericardial tissue valve and the Cox-maze III procedure for symptomatic mitral stenosis and atrial fibrillation. Following surgery, he developed atrial standstill and became pacemaker dependent...
August 25, 2016: Annals of Noninvasive Electrocardiology
Niv Ad, Sari D Holmes, Deborah Lamont, Deborah J Shuman
BACKGROUND: Growing evidence indicates the effectiveness of surgical ablation confined to the left atrium, especially with short duration of atrial fibrillation (AF) and smaller left atrial (LA) size. This study examined rhythm status and predictors of failure in this group of patients. METHODS: Of 800 patients who underwent concomitant surgical ablation (2005 to 2015), 110 had LA-only ablation. Rhythm status was defined according to Heart Rhythm Society guidelines: sinus rhythm (SR) without class I/III antiarrhythmic drugs (AADs)...
August 17, 2016: Annals of Thoracic Surgery
Jun Shi, Zhi-Xuan Bai, Ben-Gui Zhang, Wen-Jun Ren, Ying-Qiang Guo
OBJECTIVES: To determine the effectiveness of a simplified surgical treatment method for atrial fibrillation (AF). METHODS: Between September 2012 and October 2013, 120 patients (mean age, 52.3 ± 8.8 years) underwent valve surgery and concomitant bipolar radiofrequency ablation for the treatment of AF. Patients were randomized to a Cox maze IV procedure (CMP-IV) group (n = 60) or a modified CMP-IV (MCMP-IV) group (n = 60). Freedom from AF was defined as freedom from any left atrial arrhythmia lasting <30 s and no requirement of antiarrhythmic drugs after 6 months...
August 11, 2016: Interactive Cardiovascular and Thoracic Surgery
Virendra Tiwari, Manjari Singh, Jitendra K Rawat, Uma Devi, Rajnish K Yadav, Subhadeep Roy, Swetlana Gautam, Shubhini A Saraf, Vikas Kumar, Nazam Ansari, Abdulaziz S Saeedan, Gaurav Kaithwas
OBJECTIVE: The present study was aimed to enumerate the role of metformin-associated H2S release against lipopolysaccharide (LPS) induced neuroinflammation. MATERIALS AND METHODS: Five groups of animals were subjected to treatment as control (normal saline), toxic control (LPS, 125 µg/kg, i.p.), and three separate groups treated with 6.25, 12.5, and 25 mg/kg of metformin along with LPS for a period of 28 days. LPS was administered on 1st, 2nd, 3rd, 4th, 23rd, 24th, 25th and 26th day...
October 2016: Inflammopharmacology
Andrew J Borrie, Brecon H Wademan
AIM: Surgical ablation for atrial fibrillation has been performed at Wellington hospital for 10 years. This audit aims to evaluate the outcomes from surgical intervention for atrial fibrillation and identify variables affecting clinical results. METHOD: A retrospective audit of clinical outcomes was performed including all patients who had received surgical intervention for atrial fibrillation from 2004 to 2013. RESULTS: Forty-seven patients who underwent surgical intervention for atrial fibrillation were identified and reviewed...
2016: New Zealand Medical Journal
Karoly Kaszala, Kenneth A Ellenbogen
No abstract text is available yet for this article.
September 2016: Journal of Cardiovascular Electrophysiology
Ge Jin, Dafeng Bai, Shiliang Yin, Zhihang Yang, Dan Zou, Zhong Zhang, Xiaoxiu Li, Yan Sun, Qiwen Zhu
Silibinin was reported to be effective in reversing the learning and memory deficits of several AD animal models. These improvements are thought to be regulated by various factors, including antioxidative stress, inhibition of acetylcholinesterase activity and Aβ aggregation. However, there are still no reports that demonstrate the effect of silibinin on microglia activation in vivo. Thus, in this study, we used the senescence-accelerated mouse (SAMP8) strain to test the effects of silibinin on behavioral impairments and microglia activation-induced neuroinflammation...
August 26, 2016: Neuroscience Letters
Natasha A Kassim, Andrew D Althouse, Dingxin Qin, George Leef, Samir Saba
BACKGROUND: Prior research has identified gender differences in the epidemiology and clinical management of atrial fibrillation (AF). The primary aim of this study is to systematically analyze a cohort of AF men and women and evaluate their baseline demographics, treatment, and clinical outcomes by gender. METHODS: We examined the records of 5976 (42% women) consecutive AF patients who were prescribed at least one anti-arrhythmic drug between 2006 and 2013. From this cohort, 4311 (72%) patients had anticoagulation data available and were included in the final analysis...
June 1, 2016: Journal of Cardiology
Gabriella Boano, Meriam Åström Aneq, Jennie Kemppi, Farkas Vánky
OBJECTIVE: The indications for and the risk and benefit of concomitant surgical ablation for atrial fibrillation (AF) have not been fully delineated. Our aim was to survey whether the Cox-maze IV procedure is associated with postoperative heart failure (PHF) or other adverse short-term outcomes after mitral valve surgery (MVS). DESIGN: Consecutive patients with AF undergoing MVS with (n = 50) or without (n = 66) concomitant Cox-maze IV cryoablation were analysed regarding perioperative data and one-year mortality...
June 16, 2016: Scandinavian Cardiovascular Journal: SCJ
Corstiaan A den Uil, Maarten Ter Horst, Sakir Akin, Tjebbe W Galema
Surgical aortic valve replacement may be complicated by severe dynamic left ventricular outflow tract obstruction and cardiogenic shock in the postoperative period. We present a patient who developed severe anterior motion following aortic valve and Cox MAZE surgery which necessitated a mitral valve replacement. doi: 10.1111/jocs.12763 (J Card Surg 2016;31:429-431).
July 2016: Journal of Cardiac Surgery
Zhaolei Jiang, Nan Ma, Hao Liu, Min Tang, Fangbao Ding, Chunrong Bao, Ju Mei
Isolated aortic valve diseases can lead to atrial fibrillation (AF) by causing left atrium pressure overload and enlargement. At present, most patients with preoperative AF and isolated aortic valve disease have undergone a Cox-maze IV procedure through a left atriotomy under cardiopulmonary bypass with aortic cross-clamping. Here, we describe a novel modified epicardial radiofrequency ablation procedure performed on a beating heart without aortic cross-clamping or opening the left atrium. This technique has proved to be safe and feasible, with good clinical outcomes...
June 2016: Annals of Thoracic Surgery
Carlos Solis-Gaspar, Ruben A Vazquez-Roque, Ma De Jesús Gómez-Villalobos, Gonzalo Flores
The spontaneously hypertensive (SH) rat has been used as an animal model of vascular dementia (VD). Our previous report showed that, SH rats exhibited dendritic atrophy of pyramidal neurons of the CA1 dorsal hippocampus and layers 3 and 5 of the prefrontal cortex (PFC) at 8 months of age. In addition, we showed that cerebrolysin (Cbl), a neurotrophic peptide mixture, reduces the dendritic atrophy in aged animal models. This study aimed to determine whether Cbl was capable of reducing behavioral and neuronal alterations, in old female SH rats...
September 2016: Synapse
Ovidio A García-Villarreal
AIM: To compare the efectiveness of the cut-and-sew Cox-maze III procedure against the Cox-maze IV peocedure by means of intraoperative bipolar radiofrequency delivery clamp. MATERIAL: From January 2011 to October 2014, 50 patients were operated on with surgery for atrial fibrillation. All cases underwent mitral valve surgery as the first procedure, and secondarily a surgical procedure for atrial fibrillation was also performed. There were 2 groups. Group I (Cox-maze III «cut-and-sew»), and Group II (Cox-maze IV, intraoperative bipolar radiofrequency ablation)...
July 2016: Archivos de Cardiología de México
Jaspreet Kalra, Puneet Kumar, Abu Bakar Abdul Majeed, Atish Prakash
Several lines of evidence indicate that beta amyloid (β-A) production, neurofibrillary tangles and neuroinflammation are interrelated in the pathogenesis of Alzheimer's disease (AD). AD is associated with enhanced β-A production and accumulation resulting in neuroinflammation probably via activation of lipoxygenase (LOX) and cyclooxygenase (COX) pathways. Therefore, the present study was designed to investigate the role of LOX and COX inhibitors (zafirlukast and valdecoxib) in amyloidogenesis in β-A1-42 oligomer induced experimental AD in rats...
July 2016: Pharmacology, Biochemistry, and Behavior
Sheng-Tzung Tsai, Li-Jin Chen, Yueh-Jan Wang, Shin-Yuan Chen, Guo-Fang Tseng
BACKGROUND/AIMS: Rostral intralaminar thalamic nucleus (ILN) has been shown to modulate cognition through indirect connection with the hippocampus and prefrontal cortex. We explored the effects of deep brain stimulation (DBS) to the rostral ILN on spatial memory acquisition, brain neuronal activation and cortical and hippocampal synaptic changes in rats. METHODS: The Morris water maze (MWM) task was used to evaluate the spatial memory of the rats. The expression of c-fos, an immediate early gene, was used to identify neural activation in the cerebral cortex and hippocampus...
2016: Stereotactic and Functional Neurosurgery
Hongmei Ma, Li Yao, Ling Pang, Xingwei Li, Qun Yao
Tetrandrine is a bisbenzylisoquinoline alkaloid extracted from Stephania tetrandra, a traditional Chinese herbal medicine, which has been observed to exert anti‑inflammatory effects. The aim of the current study was to investigate whether tetrandrine was able to ameliorate sevoflurane‑induced cognitive impairment in aged rats. Male 20‑month‑old Sprague‑Dawley rats underwent sevoflurane‑induction in an environment containing 2% sevoflurane for 5 h. The Morris water maze test was used to measure the effect of tetrandrine on learning and memory in sevoflurane‑treated aged rats...
June 2016: Molecular Medicine Reports
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