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Cox Maze IV

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
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
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
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
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
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
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
Yi-Jing Chen, Hai-Yang Zheng, Xiu-Xian Huang, Shuang-Xue Han, Dong-Sheng Zhang, Jia-Zuan Ni, Xiao-Yang He
AIMS: This study investigated the neuroprotective properties of icariin (an effective component of traditional Chinese herbal medicine Epimedium) on neuronal function and brain energy metabolism maintenance in a triple-transgenic mouse model of Alzheimer's disease (3 × Tg-AD). METHODS: 3 × Tg-AD mice as well as primary neurons were subjected to icariin treatment. Morris water maze assay, magnetic resonance spectroscopy (MRS), Western blotting, ELISA, and immunohistochemistry analysis were used to evaluate the effects of icariin administration...
January 2016: CNS Neuroscience & Therapeutics
Takekuni Hayashi, Takeshi Mitsuhashi, Hideo Fujita, Shin-Ichi Momomura
No abstract text is available yet for this article.
May 2016: Journal of Cardiovascular Electrophysiology
Javier Gualis, Mario Castaño, Jose Manuel Martínez-Comendador, Jose Miguel Marcos, Carlos Martín, Rodrigo Estévez-Loureiro, Jesús Gómez-Plana, Elio Martín, Javier Otero
UNLABELLED: The long-term results of cryomaze in patients with longstanding persistent atrial fibrillation during concomitant surgical procedures are still uncertain. METHODS: Between 2006 and 2011, 150 consecutive patients with associated long-lasting permanent atrial fibrillation and associated heart disease underwent heart surgery were treated by biatrial Cox-Maze (63 patients) or by isolated endocardial or epicardial left atrial cryoablation (83 patients) concomitantly...
April 2016: Archivos de Cardiología de México
Christopher P Lawrance, Matthew C Henn, Ralph J Damiano
No abstract text is available yet for this article.
September 2015: Annals of Cardiothoracic Surgery
Matthew C Henn, Timothy S Lancaster, Jacob R Miller, Laurie A Sinn, Richard B Schuessler, Marc R Moon, Spencer J Melby, Hersh S Maniar, Ralph J Damiano
OBJECTIVE: The Cox maze IV procedure (CMPIV) has been established as the gold standard for surgical ablation; however, late outcomes using current consensus definitions of treatment failure have not been well described. To compare to reported outcomes of catheter-based ablation, we report our institutional outcomes of patients who underwent a left-sided or biatrial CMPIV at 5 years of follow-up. METHODS: Between January 2002 and September 2014, data were collected prospectively on 576 patients with AF who underwent a CMPIV (n = 532) or left-sided CMPIV (n = 44)...
November 2015: Journal of Thoracic and Cardiovascular Surgery
Vigneshwar Kasirajan, Sadia Sayeed, Elizabeth Filler, Arkun Knarik, Jayanthi N Koneru, Kenneth A Ellenbogen
BACKGROUND: The Cox maze IV operation has become the preferred surgical treatment for atrial fibrillation, as it is associated with less morbidity and complexity than the Cox maze III procedure, yet is still highly effective. Numerous studies have been conducted in animals to examine the histopathology of this operation on the heart but studies on human hearts that have undergone the Cox maze IV operation have not been performed. METHODS: We report the histopathologic findings in 3 patients from whom tissue was available for histologic study...
February 2016: Annals of Thoracic Surgery
Jonathan M Philpott, Christian W Zemlin, James L Cox, Mack Stirling, Michael Mack, Robert L Hooker, Allen Morris, David A Heimansohn, James Longoria, Divyakant B Gandhi, Patrick M McCarthy
BACKGROUND: The Cox Maze-IV procedure (CMP-IV) has replaced the Cox Maze-III procedure as the most common approach for the surgical treatment of atrial fibrillation (AF). The Food and Drug Administration-regulated AtriCure Bipolar Radiofrequency Ablation of Permanent Atrial Fibrillation (ABLATE) trial sought to demonstrate the safety and efficacy of the CMP-IV performed with the Synergy ablation system (AtriCure, Inc, Cincinnati, OH). METHODS: Fifty-five patients (aged 70...
November 2015: Annals of Thoracic Surgery
Basel Ramlawi, Walid K Abu Saleh
The Cox-maze procedure for the restoration of normal sinus rhythm, initially developed by Dr. James Cox, underwent several iterations over the years. The main concept consists of creating a series of transmural lesions in the right and left atria that disrupt re-entrant circuits responsible for propagating the abnormal atrial fibrillation rhythm. The left atrial appendage is excluded as a component of the Maze procedure. For the first three iterations of the Cox- maze procedure, these lesions were performed using a surgical cut-and-sew approach that ensured transmurality...
April 2015: Methodist DeBakey Cardiovascular Journal
Timothy S Lancaster, Spencer J Melby, Ralph J Damiano
The surgical treatment of atrial fibrillation (AF) has been revolutionized over the past two decades through surgical innovation and improvements in endoscopic imaging, ablation technology, and surgical instrumentation. These advances have prompted the development of the less complex and less morbid Cox-Maze IV procedure, and have allowed its adaptation to a minimally invasive right mini-thoracotomy approach that can be used in stand-alone AF ablation and in patients undergoing concomitant mitral and tricuspid valve surgery...
April 2016: Trends in Cardiovascular Medicine
Matthew C Henn, Christopher P Lawrance, Laurie A Sinn, Jacob R Miller, Richard B Schuessler, Marc R Moon, Spencer J Melby, Hersh S Maniar, Ralph J Damiano
BACKGROUND: In patients with atrial fibrillation (AF), the addition of surgical ablation to aortic valve replacement (AVR) does not increase procedural morbidity or mortality. However, efficacy in this population has not been carefully evaluated. This study compared outcomes between patients undergoing stand-alone Cox-Maze IV with those undergoing surgical ablation and concomitant AVR. METHODS: From January 2002 to May 2014, 188 patients received a stand-alone Cox-Maze IV (n = 113) or surgical ablation with concomitant AVR (n = 75)...
October 2015: Annals of Thoracic Surgery
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