The effect of the Cox-maze procedure for atrial fibrillation concomitant to mitral and tricuspid valve surgery

Abstract

In our center, 76% of patients undergoing mitral valve or mitral valve+tricuspid valve surgery experiencing AF underwent concomitant Cox-maze procedure, which is considerably higher than the national average. No increased morbidity was associated with the Cox-maze procedure with the benefit of very low thromboembolic rate. These results suggest the need for performance-based education for AF surgical ablation to achieve optimal outcomes.

Surgical ablation of atrial fibrillation in patients with a giant left atrium undergoing mitral valve surgery

“…Because AF is known to be associated with LA enlargement,28 and both an enlarged LA and AF are well-known predisposing factors of TR,29 30 the restoration of the sinus rhythm seems to help prevent the progression of TR and contribute to restoring LA size. Admittedly, restoring the sinus rhythm does not solely account for such benefits; a smaller LA size could be partially attributed to LA reduction performed in 78.3% of the maze group patients.…”

Expert consensus guidelines: Examining surgical ablation for atrial fibrillation

“…Of these studies, 87 were reviewed in depth for inclusion, and 20 ultimately met all inclusion criteria. 13,18,[22][23][24][26][27][28][30][31][32][33][35][36][37][38][39][40][41][42] The remaining 67 studies were excluded because of no comparison group (n ¼ 23), catheter ablation rather than surgical ablation (n ¼ 17), duplicate data (n ¼ 10), no ablation (n ¼ 7), reviews (n ¼ 6), and no outcome data (n ¼ 4).…”

Surgical management of atrial fibrillation at the time of septal myectomy

“…HCM is in the group of aortic valve diseases, but its pathophysiology is markedly different from that of valvular aortic stenosis. Early success with concomitant AF ablation associated with non-HCM aortic valve disease and mitral valve disease is above 75% in the absence of the classical risk factors for poor prognosis (age beyond 75, LA Diameter over 50 mm, duration of AF more than 5 years and non-paroxysmal AF) (13,14). For concomitant AF ablative surgery, outcomes with the classic Maze III lesion pattern (either cut-and-sew or cryoablation) can be expected to be superior to those achieved with "modifications" of the original lesion set (15,16).…”