Partial Maze Procedure Is Effective Treatment for Chronic Atrial Fibrillation Associated with Valve Disease

The maze procedure may be performed in combination with valve operations to treat chronic atrial fibrillation associated with valve dysfunction. Although we initially used the modified Cox maze III procedure, a more limited partial maze procedure is now preferred because the left atrium might be considered as the electrical impetues for atrial fibrillation. In this study we compared the results of 30 patients (group I) who underwent the full biatrial modified Cox maze III and 20 (group II) patients the partial maze procedure. While the rates of restored sinus rhythm were the same in both groups at 6‐month follow‐up (I: 83.3%, vs II: 80%), the following advantages were noted in the patients undergoing the partial maze procedure: shorter operative times, lesser elevations of creatine phosphokinase, lower rate of blood transfusion, lower rate of junc‐tional rhythm soon after the operation, and a higher P wave in those patients with restored sinus rhythm. The effectiveness of the partial maze procedure seems equal to that of the biatrial modified Cox maze III procedure for atrial fibrillation associated with valve disease. The partial maze procedure is simple and less invasive, and thus might be applied more frequently as an additional procedure to valve operations without additional risk.

[1]  Y. Kawashima,et al.  The outcome and indications of the Cox maze III procedure for chronic atrial fibrillation with mitral valve disease. , 1998, The Journal of thoracic and cardiovascular surgery.

[2]  K. Yeh,et al.  Radiofrequency and cryoablation of atrial fibrillation in patients undergoing valvular operations. , 1998, The Annals of thoracic surgery.

[3]  S. Muraki,et al.  Is atrial fibrillation resulting from rheumatic mitral valve disease a proper indication for the maze procedure? , 1998, The Annals of thoracic surgery.

[4]  T. Ohkubo,et al.  Predictors of sinus rhythm restoration after Cox maze procedure concomitant with other cardiac operations. , 1997, The Annals of thoracic surgery.

[5]  K. Kawazoe,et al.  Electrocardiographic nature of restored sinus rhythm after Cox maze procedure in patients with chronic atrial fibrillation who also had other cardiac surgery. , 1997, Heart.

[6]  T. Sueda,et al.  Simple left atrial procedure for chronic atrial fibrillation associated with mitral valve disease. , 1996, The Annals of thoracic surgery.

[7]  J L Cox,et al.  An 8 1/2-year clinical experience with surgery for atrial fibrillation. , 1996, Annals of surgery.

[8]  P. Coumel,et al.  Electrophysiological effects of catheter ablation of inferior vena cava-tricuspid annulus isthmus in common atrial flutter. , 1996, Circulation.

[9]  Y. Kawashima,et al.  Cox maze procedure for chronic atrial fibrillation associated with mitral valve disease. , 1994, The Journal of thoracic and cardiovascular surgery.

[10]  J. Fisher,et al.  Combined treatment of mitral stenosis and atrial fibrillation with valvuloplasty and a left atrial maze procedure. , 1994, The Journal of thoracic and cardiovascular surgery.

[11]  J. Cox Evolving applications of the maze procedure for atrial fibrillation. , 1993, The Annals of thoracic surgery.

[12]  M. Viganó,et al.  Left atrial isolation associated with mitral valve operations. , 1992, The Annals of thoracic surgery.

[13]  G. Guiraudon,et al.  Surgical therapy of paroxysmal atrial fibrillation with the "corridor" operation. , 1992, The Annals of thoracic surgery.

[14]  J L Cox,et al.  The surgical treatment of atrial fibrillation. IV. Surgical technique. , 1991, The Journal of thoracic and cardiovascular surgery.

[15]  A. Harada,et al.  Atrial activation during chronic atrial fibrillation in patients with isolated mitral valve disease. , 1996, The Annals of thoracic surgery.