Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience.

Hartzell V Schaff, J. A. Dearani, R. C. Daly, T. A. Orszulak, G. K. Danielson

Research output: Contribution to journalArticle

175 Citations (Scopus)

Abstract

The Cox-Maze procedure corrects atrial fibrillation in 90% of patients, and successful operation restores sinus rhythm, thereby reducing risks of thromboembolism and anticoagulant-associated hemorrhage. Symptoms such as palpitation and fatigability also improve with restoration of atrioventricular synchrony. At the Mayo Clinic, 221 Cox-Maze procedures were performed from March 1993 through March 1999. Over 75% of patients had associated cardiac disease and concomitant operations. Overall, early mortality was 1.4%, and the incidence of postoperative pacemaker implantation was 3.2%. Limiting incisions to the right atrium simplifies the operation for patients who primarily have tricuspid valve disease, and in early follow-up, outcome appeared to be as good as that achieved with biatrial incisions. The Cox-Maze procedure has proved particularly useful for patients with preoperative atrial fibrillation who require valvuloplasty for acquired mitral valve regurgitation; 87 patients have had this combined procedure, and there have been no early deaths. Further, our experience indicates that ventricular dysfunction is not a contraindication for operation and that restoration of sinus rhythm after the Cox-Maze procedure improves left ventricular ejection fraction in most patients.

Original languageEnglish (US)
Pages (from-to)30-37
Number of pages8
JournalSeminars in Thoracic and Cardiovascular Surgery
Volume12
Issue number1
StatePublished - Jan 2000

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Atrial Fibrillation
Ventricular Dysfunction
Tricuspid Valve
Thromboembolism
Mitral Valve Insufficiency
Heart Atria
Stroke Volume
Anticoagulants
Heart Diseases
Hemorrhage
Mortality
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Schaff, H. V., Dearani, J. A., Daly, R. C., Orszulak, T. A., & Danielson, G. K. (2000). Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience. Seminars in Thoracic and Cardiovascular Surgery, 12(1), 30-37.

Cox-Maze procedure for atrial fibrillation : Mayo Clinic experience. / Schaff, Hartzell V; Dearani, J. A.; Daly, R. C.; Orszulak, T. A.; Danielson, G. K.

In: Seminars in Thoracic and Cardiovascular Surgery, Vol. 12, No. 1, 01.2000, p. 30-37.

Research output: Contribution to journalArticle

Schaff, HV, Dearani, JA, Daly, RC, Orszulak, TA & Danielson, GK 2000, 'Cox-Maze procedure for atrial fibrillation: Mayo Clinic experience.', Seminars in Thoracic and Cardiovascular Surgery, vol. 12, no. 1, pp. 30-37.
Schaff, Hartzell V ; Dearani, J. A. ; Daly, R. C. ; Orszulak, T. A. ; Danielson, G. K. / Cox-Maze procedure for atrial fibrillation : Mayo Clinic experience. In: Seminars in Thoracic and Cardiovascular Surgery. 2000 ; Vol. 12, No. 1. pp. 30-37.
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