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Cox maze procedure

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
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
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
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
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
J S Han, H S Wang, Z W Wang, Z T Yin, H G Han, C Y Tang
OBJECTIVE: To evaluate the safety and efficacy of cut-and-sew Cox-Maze (CM) Ⅲ procedure for patients with atrial fibrillation associated with rheumatic mitral valve disease. METHODS: Patients received mitral valve replacement and CM procedure between January 2007 and July 2015, were 1∶1 matched and assigned to CM Ⅳ group (undergoing surgical ablation) and CM Ⅲ group (undergoing cut-and-sew CM Ⅲ). Safety indices, mortality rate, complications and recovery rate of sinus rhythm were compared between the two groups...
April 5, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Christoph Haller, Joel A Kirsh, Glen Van Arsdell, Osami Honjo
Modifications of conventional ablation strategies can make arrhythmia surgery more efficient after primary sutureless repair of total anomalous pulmonary venous drainage. We present a surgical technique performed in a 3-year-old patient who experienced ongoing atrial arrhythmia after sutureless repair. A new modified Cox-Maze IV procedure was performed, which respects the special characteristics of patients after sutureless repairs, showing good short-term results.
April 2016: Annals of Thoracic Surgery
Christopher P Lawrance, Matthew C Henn, Ralph J Damiano
Atrial fibrillation is the most common cardiac arrhythmia, and its treatment options include drug therapy or catheter-based or surgical interventions. The surgical treatment of atrial fibrillation has undergone multiple evolutions over the last several decades. The Cox-Maze procedure went on to become the gold standard for the surgical treatment of atrial fibrillation and is currently in its fourth iteration (Cox-Maze IV). This article reviews the indications and preoperative planning for performing a Cox-Maze IV procedure...
April 2016: Heart Failure Clinics
Kaushal Kishore Tiwari, Tommaso Gasbarri, Stefano Bevilacqua, Mattia Glauber
BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia diagnosed in humans and therefore causes a high socioeconomic burden. The Cox-Maze IV procedure is the gold standard treatment for atrial fibrillation. Minimally invasive surgery for the treatment of AF is also promising. OBJECTIVES: Our aim is to evaluate the feasibility, safety, and immediate plus medium-term results of concomitant AF ablation therapy in patients undergoing minimally invasive valve surgery through right-sided minithoracotomy...
May 2016: Research in Cardiovascular Medicine
Jens Vikse, Brandon Michael Henry, Joyeeta Roy, Piravin Kumar Ramakrishnan, Wan Chin Hsieh, Jerzy A Walocha, Krzysztof A Tomaszewski
BACKGROUND AND OBJECTIVE: The sinoatrial nodal artery (SANa) is a highly variable vessel which supplies blood to the sinoatrial node (SAN). Due to its variability and susceptibility to iatrogenic injury, our study aimed to assess the anatomy of the SANa and determine the prevalence of its anatomical variations. STUDY DESIGN: An extensive search of major electronic databases was performed to identify all articles reporting anatomical data on the SANa. No lower date limit or language restrictions were applied...
2016: PloS One
Katerina Kyprianou, Agamemnon Pericleous, Antonio Stavrou, Inetzi A Dimitrakaki, Dimitrios Challoumas, Georgios Dimitrakakis
Atrial fibrillation (AF) is the most common cardiac arrhythmia and a huge public health burden associated with significant morbidity and mortality. For decades an increasing number of patients have undergone surgical treatment of AF, mainly during concomitant cardiac surgery. This has sparked a drive for conducting further studies and researching this field. With the cornerstone Cox-Maze III "cut and sew" procedure being technically challenging, the focus in current literature has turned towards less invasive techniques...
January 26, 2016: World Journal of Cardiology
Vinay Badhwar
No abstract text is available yet for this article.
April 2016: Journal of Thoracic and Cardiovascular Surgery
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